Virtual surgical planning and patient-specific design driven by emerging technologies

In recent years, the integration of emerging technologies in surgery has facilitated the development of innovative approaches to improve preoperative planning and surgical performance. This dissertation provides a comprehensive investigation into the application of emerging engineering technologies – such as computer-aided design, 3D printing, and extended reality – to develop patient-specific models and instruments, addressing the increasing demand for precision and personalization in surgical treatment. The methodology involved the development of a structured workflow that combines engineering and medical expertise, integrating advanced imaging technologies – including computed tomography and magnetic resonance imaging – with 3D segmentation and 3D modeling software. Furthermore, the study explored additive manufacturing technologies, including fused deposition modeling, stereolithography, and laser powder bed sintering, as well as a range of 3D printing materials. These ranged from basic polymers, such as polylactic acid and thermoplastic polyurethane, to more advanced materials like polyether-ether-ketone and titanium alloy. The findings of this research have been successfully translated into clinical scenarios, enabling continuous refinement of both the workflow and surgical techniques to achieve increasingly patient-specific and innovative design. The results highlight the effectiveness of technology integration in surgical planning, demonstrating a significant reduction in operative time and intraoperative fluoroscopy exposure. The use of custom-made instruments has proven to be reliable and safe, offering economic and operational advantages. In addition, experimental research has led to promising developments, such as the design of lattice structures for bone grafts and implants with improved osseointegration properties. Looking beyond the present, this research underscores the growing trend towards novel paradigms, including the establishment of in-hospital 3D laboratories for virtual surgical planning and the point-of-care fabrication of patient-specific devices. These advancements are poised to drive a transformative evolution in surgical care, fostering a new era of precision medicine and personalized treatment strategies.