In December, 2011, Prof. Pillip Blondeel headed a team* including 3 other surgeons (Prof. H. Vermeersch, Dr. N. Roche, Dr. F. Stillaert) at the University Hospital of Ghent, to successfully perform Belgium's first full face transplant. The operation was a major step forward as it involved not only skin and muscle but also the major portion of the facial midface skeletal bone, making the world's 19th face transplant one of the most complex procedures carried out so far. The team was able to push the limits of what was possible, in part, thanks to their extensive use of digital imaging and 3D Printing for the planning and execution of the procedure - aided by clinical engineers at Materialise using Synthes ProPlan CMFTM software.
Choosing the Best Treatment for a Patient in Need:
The recipient of Belgium's first face transplant suffered from a severe trauma that resulted in a complex facial deformity affecting both his soft tissue and bone. It was only thanks to the incredible skills of the surgeons who first treated him that this patient managed to survive his trauma at all. Then, after his condition was stabilized and a face transplant was identified as the best method to regain a better quality of life, it was up to the remarkable skills and perseverance of Prof. Pillip Blondeel and his team to make it happen.
Planning in 3D Using Synthes ProPlan CMFTM Software:
Planning and preparations began long before the actual procedure took place as the team needed to act quickly and efficiently when a suitable donor was found.
To begin, the team took a CT scan of the patient and using the data collected, clinical engineers at Materialise constructed a digital representation of the patient's anatomy in Synthes ProPlan CMF. A scan was also taken of a healthy skull with similar anatomical characteristics to the patient in order to define the bone and soft tissue that would need to be harvested for the transplant. Using Synthes ProPlan CMF, clinical engineers at Materialise worked closely with the surgical team in order to create a comprehensive surgical plan based on this 3D data.
In order to put the surgical plan into action, anatomical models and patient specific surgical guides were 3D printed for use before and during the operation. The anatomical skull models allowed the surgeons to see under the skin of the patient and get a real feel for the situation. They also served as an important reference tool during the procedure itself. The printed guides were used to indicate where bone needed to be harvested from the donor as well as the amount and shape required.
When a suitable donor was found, the moment came for Prof. Pillip Blondeel and his team to put the carefully prepared plan into action. Soft tissue and damaged bone were removed from the patient while the required bone and soft tissue were being harvested by a parallel surgical team from the donor. The bone was then fixed in place using plates and screws. Next, blood vessels and nerves were connected and finally, the soft tissue was sutured together.
Achieving Success for Belgium's First Face Transplant:
To date, with the recovery process of the patient already surpassing the surgical team's expectations in the months following the surgery, Belgium's first face transplant is being considered a great success. Both the patient and the entire surgical team are extremely grateful to the donor and his family as none of this would have been possible without their generous sacrifice. A member of the surgical team (famed anaplastologist, Jan De Cubber) used an anatomical model to create an epithesis of the donor. This was then presented to the donor's family, allowing them to see him once more after he passed away.
* A team of approximately 65 people, including the surgeons Prof. Pillip Blondeel, Prof. Hubert Vermeersch, Dr. Nathalie Roche, Dr. Filip Stillaert, anaplastologist Jan De Cubber, and 15 medical and 14 paramedical services from within the University Hospital of Ghent spent almost three years preparing for this procedure.
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