TWI803366B - Additive manufacturing method for making three-dimensional pre-post-operative status multicolor holistic model in the same batch - Google Patents
Additive manufacturing method for making three-dimensional pre-post-operative status multicolor holistic model in the same batch Download PDFInfo
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本發明係關於一種積層製造方法，尤其是一種在同一批次製程中製造三維術前術後狀態全模型之積層製造方法，所製造之三維術前術後狀態全模型能將手術部位在術前與術後之差異呈現於單一多色三維實體模型上。 The present invention relates to a layered manufacturing method, especially a layered manufacturing method for manufacturing a three-dimensional preoperative and postoperative state full model in the same batch process. The manufactured three-dimensional preoperative and postoperative state full model can make the surgical part Differences from postoperative are presented on a single multicolor 3D solid model.
在習用外科手術技術中，外科醫生(surgeon)在對病患進行術前或病況說明時，最困難之處在於，如何將抽象的手術位置、手術方向與術後狀態等資訊在術前向病患具體且準確的說明，讓病患明瞭且不至於產生錯誤認知或期待，與如何將高度專業的醫學名詞及人體解剖構造向沒有醫學背景的病患以淺顯易懂方式說明讓病患充分理解，這些困難往往是造成後續醫病關係緊張的根源。 In conventional surgical techniques, the most difficult thing for a surgeon (surgeon) to explain to a patient before operation or condition is how to convey the abstract information such as the operation location, operation direction, and postoperative status to the patient before operation. Specific and accurate explanations for patients, so that patients can understand without misunderstanding or expectations, and how to explain highly professional medical terms and human anatomy to patients without medical background in an easy-to-understand way so that patients can fully understand , These difficulties are often the source of tension in the follow-up doctor-patient relationship.
以整形醫學為例，整形手術中常見的顴骨切削與下顎削骨，這類整形削骨手術是將小部分骨頭切下，然後對其原本位置進行微小調整，可能是一點點內推然後重新固定，藉此修改臉部輪廓，使臉部呈現窄縮(tapered)外觀，同時也有縮小臉部正面大小的效果。在切削手術執行前， 醫師通常運用電腦斷層掃描(CT)影像或者X光影像等二維醫學影像，進行手術規劃(PP)，並在術前說明時利用這些影像，頂多再配合制式人體構造模型，向病患解說手術部位、手術位置、手術效果及術後狀態等。 Taking plastic surgery as an example, cheekbone cutting and mandibular bone cutting are common in plastic surgery. This kind of plastic bone cutting surgery is to cut off a small part of the bone, and then make small adjustments to its original position, maybe a little push in and then re- Fixed, which modifies the contours of the face, giving the face a tapered appearance and also has the effect of reducing the frontal size of the face. Before the ablation procedure is performed, Physicians usually use two-dimensional medical images such as computerized tomography (CT) images or X-ray images to carry out surgical planning (PP), and use these images in preoperative explanations, at most, with standard human structure models to explain to patients Surgical site, surgical location, surgical effect and postoperative status, etc.
然而，雖然有二維醫學影像或人體模型可供參考，但對於毫無醫學背景及首次做整形手術的病患而言，不一定能理解專業醫學影像與人體構造，也不易將平面影像轉換成立體實物想像，也很難理解醫學術語真正含意，對於醫師的說明可能是似懂非懂，或只能片段理解，對於切下的骨頭大小、實際切削位置及內推距離，尤其是術後臉部輪廓狀態等，有可能都還不是很清楚或只憑藉想像，導致病患有可能在錯誤認知的情境下，或是在未充分理解但又不得不做選擇的情境下，做出手術決定，並懷抱不合理期待。 However, although there are two-dimensional medical images or human body models for reference, for patients who have no medical background and undergo plastic surgery for the first time, they may not be able to understand professional medical images and human body structure, and it is not easy to convert planar images into It is also difficult to understand the real meaning of medical terms through three-dimensional physical imagination. The doctor’s explanation may be half-understood, or can only be understood in fragments. The state of facial contour, etc., may not be very clear or only rely on imagination, leading to the possibility that the patient may make a surgical decision under the situation of wrong cognition, or under the situation of not fully understanding but having to make a choice, And embrace unreasonable expectations.
但有相當經驗的外科醫生知道，面對缺少醫學背景的一般病患，往往較難僅憑二維的醫學影像，就能讓病患完整理解狀況，因此當術後手術實際結果與病患的術前期待有落差時，往往造成病患與醫生間之信任關係破裂，導致醫病關係對立，甚至對簿公堂。 However, experienced surgeons know that it is often difficult for patients with a lack of medical background to fully understand the situation with only two-dimensional medical images. When there is a gap in preoperative expectations, it often leads to a breakdown in the trust relationship between patients and doctors, leading to antagonism between doctors and patients, and even lawsuits.
職是之故，有鑑於習用技術中存在的缺點，發明人經過悉心嘗試與研究，並一本鍥而不捨之精神，終構思出本案「同批次製造三維術前術後狀態多色全模型之積層製造方法」，能夠克服上述缺點，以下為本發明之簡要說明。 For this reason, in view of the shortcomings in the conventional technology, the inventor has tried and researched carefully, and with a persistent spirit, he finally conceived the case of "manufacturing the same batch of three-dimensional pre-operative and post-operative multi-color full model lamination Manufacturing method ", can overcome above-mentioned shortcoming, the following is a brief description of the present invention.
本發明係關於一種積層製造方法，尤其是一種在同一批次製程中製造三維術前術後狀態多色全模型之積層製造方法，所製造之三維術 前術後狀態全模型能將手術部位在術前與術後之差異表現於單一三維多色實體模型上，而在同一批次製程中製造三維術前術後狀態多色全模型，將有效縮短製程時間有利快速製造並簡化製造步驟。 The present invention relates to a layered manufacturing method, especially a layered manufacturing method for manufacturing multi-color full models of three-dimensional pre-operative and post-operative states in the same batch process. The manufactured three-dimensional surgical The full model of the pre- and post-operative state can express the difference between the pre-operative and post-operative parts of the surgical site on a single 3D multi-color solid model, and the production of the 3-D pre- and post-operative state multi-color full model in the same batch process will effectively shorten the The process time facilitates fast manufacturing and simplifies manufacturing steps.
據此本發明提出一種積層製造方法，其包含：在手術部位術前三維模型上標記手術面並據此建立手術面三維模型；實施布林運算以根據該手術面從該手術部位術前三維模型上獲得切削部位三維模型，以及從該手術部位術前三維模型上移除該切削部位三維模型獲得手術部位術中三維模型；以及實施積層製造並在同一批次製程中製造包含該手術部位術中三維模型、該手術面三維模型與該切削部位三維模型之三維術前術後狀態多色全模型之實體模型。 According to this, the present invention proposes a kind of laminated manufacturing method, which includes: marking the surgical surface on the preoperative three-dimensional model of the surgical site and establishing the three-dimensional model of the surgical surface accordingly; Obtaining a three-dimensional model of the cutting site, and removing the three-dimensional model of the cutting site from the preoperative three-dimensional model of the surgical site to obtain an intraoperative three-dimensional model of the surgical site; and implementing additive manufacturing and manufacturing the three-dimensional model containing the surgical site in the same batch . The three-dimensional model of the surgical surface and the three-dimensional model of the cutting site, a solid model of a multi-color full model of the three-dimensional preoperative and postoperative state.
所述之積層製造方法，還包含以下其中之一：由第一人員實施三維建模技術將複數二維醫學影像重建為該手術部位術前三維模型；由第二人員在該手術部位術前三維模型上標記該手術面；由第三人員依據該手術面建立該手術面三維模型；由第四人員實施交集運算以根據該手術面從該手術部位術前三維模型上獲得該切削部位三維模型；由第五人員實施差集運算以根據從該手術部位術前三維模型上移除該切削部位三維模型獲得該手術部位術中三維模型；由第六人員修改該手術部位術中三維模型與該切削部位三維模型，以分別在該手術部位術中三維模型與該切削部位三維模型中形成第一接點與第二接點以形成移動接點；由第七人員根據該手術部位術中三維模型、該手術面三維模型與該切削部位三維模型規劃切層路徑生成計畫；以及由第八人員實施該積層製造並在同一批次製程中製造包含該手術部位術中三維模型、該手術面三維模型與該切削部位三維模型 之三維術前術後狀態多色全模型。 The additive manufacturing method further includes one of the following: the first person implements three-dimensional modeling technology to reconstruct the complex two-dimensional medical images into a preoperative three-dimensional model of the surgical site; The operation surface is marked on the three-dimensional model; the third person establishes the three-dimensional model of the operation surface according to the operation surface; the fourth person performs intersection operation to obtain the three-dimensional model of the cutting site from the preoperative three-dimensional model of the operation site according to the operation surface The fifth person implements difference operation to obtain the intraoperative three-dimensional model of the surgical site by removing the three-dimensional model of the cutting site from the preoperative three-dimensional model of the surgical site; the sixth person modifies the three-dimensional model of the surgical site during operation and the three-dimensional model of the cutting site a three-dimensional model to form a first joint and a second joint in the intraoperative three-dimensional model of the surgical site and the three-dimensional model of the cutting site respectively to form a moving joint; The 3D model and the 3D model of the cutting part plan the slice path generation plan; and the eighth person implements the additive manufacturing and manufactures the intraoperative 3D model of the surgical site, the 3D model of the surgical surface and the cutting part in the same batch process 3D model The multi-color full model of the 3D preoperative and postoperative state.
較佳的，該第一接點與該第二接點之結構幾何形狀為互補，當該第一接點與該第二接點對準後，該手術部位術中三維模型與該切削部位三維模型之對應實體將透過該移動接點以可移動之方式組合在一起，使得該切削部位三維模型之實體模型能相對於該手術部位術中三維模型之實體模型進行移動。 Preferably, the structural geometry of the first contact point and the second contact point are complementary, when the first contact point and the second contact point are aligned, the intraoperative three-dimensional model of the surgical site and the three-dimensional model of the cutting site The corresponding entities will be combined in a movable manner through the moving joint, so that the solid model of the three-dimensional model of the cutting part can move relative to the solid model of the intraoperative three-dimensional model of the operation site.
較佳的，該第一人員、該第二人員、該第三人員、該第四人員、該第五人員、該第六人員、該第七人員與該第八人員係為同一人或者不同一人。 Preferably, the first person, the second person, the third person, the fourth person, the fifth person, the sixth person, the seventh person and the eighth person are the same person or different persons .
較佳的，該三維術前術後狀態全模型之實體模型能將術前與術後之差異性同時呈現。 Preferably, the solid model of the three-dimensional preoperative and postoperative state full model can present the differences between preoperative and postoperative at the same time.
上述發明內容旨在提供本揭示內容的簡化摘要，以使讀者對本揭示內容具備基本的理解，此發明內容並非揭露本發明的完整描述，且用意並非在指出本發明實施例的重要/關鍵元件或界定本發明的範圍。 The above summary of the invention is intended to provide a simplified summary of the disclosure to enable readers to have a basic understanding of the disclosure. This summary of the invention is not intended to disclose a complete description of the invention, and is not intended to point out important/key elements or components of the embodiments of the invention. define the scope of the invention.
2:顴骨 2: Cheekbone
4:L形切口 4: L-shaped cut
6:I形切口 6: I-shaped incision
8:切削部位 8: Cutting part
10:手術部位術前3D模型 10: Preoperative 3D model of the surgical site
11:手術面3D模型 11: 3D model of surgical surface
11p:手術面 11p: Surgical surface
20:預定切削部位3D模型 20: 3D model of planned cutting part
20p:預定切削部位 20p: scheduled cutting position
21:矩形凹部 21: Rectangular recess
30:手術部位術中3D模型 30: Intraoperative 3D model of surgical site
31:矩形凸部 31: Rectangular convex part
40:移動接點 40: Mobile contact
50:3D術前術後狀態多色全模型 50: 3D multi-color full model of preoperative and postoperative status
100:同批次製造三維術前術後狀態多色全模型積層製造方法 100: Multi-color full model lamination manufacturing method for manufacturing 3D preoperative and postoperative states in the same batch
101~108:實施步驟 101~108: Implementation steps
第1A圖係揭示本發明實施例所應用之面部顴骨切削手術示意圖； Fig. 1A is a schematic diagram showing the facial zygoma resection operation applied in the embodiment of the present invention;
第1B圖係揭示本發明實施例所應用之面部顴骨切削手術所切削之L形顴骨片段之示意圖； Figure 1B is a schematic diagram showing the L-shaped zygomatic segment cut by the facial zygomatic surgery applied in the embodiment of the present invention;
第2圖係揭示經由實施本發明方法所製造之手術部位術前3D模型之示意圖； Figure 2 is a schematic diagram showing the preoperative 3D model of the surgical site manufactured by implementing the method of the present invention;
第3A圖係揭示經由實施本發明方法所製造之手術部位術前3D模型上 包含之手術面及切削部位之前視示意圖； Figure 3A shows the preoperative 3D model of the surgical site manufactured by implementing the method of the present invention Schematic diagram of the front view of the surgical surface and cutting site included;
第3B圖係揭示經由實施本發明方法所製造之手術部位術前3D模型上包含之手術面及切削部位之立體透視示意圖； Fig. 3B is a three-dimensional perspective schematic diagram showing the surgical surface and cutting site included in the preoperative 3D model of the surgical site manufactured by implementing the method of the present invention;
第4A圖係揭示經由實施本發明方法所製造之手術面3D模型之前視示意圖； Figure 4A is a schematic diagram showing the front view of the 3D model of the surgical surface manufactured by implementing the method of the present invention;
第4B圖係揭示經由實施本發明方法所製造之手術面3D模型之立體透視示意圖； Fig. 4B is a three-dimensional perspective schematic diagram showing the 3D model of the surgical surface manufactured by implementing the method of the present invention;
第5A圖係揭示經由實施本發明方法所製造之切削部位3D模型之前視示意圖； Figure 5A is a schematic front view showing the 3D model of the cutting part manufactured by implementing the method of the present invention;
第5B圖係揭示經由實施本發明方法所製造之切削部位3D模型之立體透視示意圖； Figure 5B is a schematic perspective view showing a 3D model of a cutting part manufactured by implementing the method of the present invention;
第6A圖係揭示經由實施本發明方法所製造之手術部位在手術過程中經過切削後之3D模型之前視示意圖； Fig. 6A is a schematic diagram showing the front view of the 3D model of the surgical site manufactured by implementing the method of the present invention after cutting during the surgical procedure;
第6B圖係揭示經由實施本發明方法所製造之手術部位在手術過程中經過切削後之3D模型之立體透視示意圖； Fig. 6B is a three-dimensional perspective schematic diagram showing the 3D model of the surgical site manufactured by implementing the method of the present invention after cutting during the surgical procedure;
第7A圖係揭示經由實施本發明方法所製造之三維術前術後狀態多色全模型之前視示意圖與凹部與凸部之放大示意圖； Fig. 7A is a front view schematic diagram and an enlarged schematic diagram of the concave and convex parts of the multi-color full model of the three-dimensional preoperative and postoperative state manufactured by implementing the method of the present invention;
第7B圖係揭示經由實施本發明方法所製造之三維術前術後狀態多色全模型之立體透視示意圖與凹部與凸部之放大示意圖；以及 Fig. 7B is a three-dimensional perspective schematic diagram and an enlarged schematic diagram of concave and convex parts of the multi-color full model of the three-dimensional preoperative and postoperative state manufactured by implementing the method of the present invention; and
第8圖揭示本發明同批次製造三維術前術後狀態多色全模型積層製造方法之實施步驟流程圖。 Fig. 8 discloses a flow chart of the implementation steps of the multi-color full-model laminated manufacturing method for manufacturing the three-dimensional pre-operative and post-operative state in the same batch of the present invention.
本發明將可由以下的實施例說明而得到充分瞭解，使得熟習本技藝之人士可以據以完成之，然本發明之實施並非可由下列實施案例而被限制其實施型態；本發明之圖式並不包含對大小、尺寸與比例尺的限定，本發明實際實施時其大小、尺寸與比例尺並非可經由本發明之圖式而被限制。 The present invention can be fully understood by the following examples, so that those skilled in the art can complete it, but the implementation of the present invention can not be limited by the following examples of implementation; the drawings of the present invention are not limited No limitation on size, dimension and scale is included, and the size, dimension and scale of the present invention are not limited by the drawings of the present invention during the actual implementation.
本文中用語“較佳”是非排他性的，應理解成“較佳為但不限於”，任何說明書或請求項中所描述或者記載的任何步驟可按任何順序執行，而不限於請求項中所述的順序，本發明的範圍應僅由所附請求項及其均等方案確定，不應由實施方式示例的實施例確定；本文中用語“包含”及其變化出現在說明書和請求項中時，是一個開放式的用語，不具有限制性含義，並不排除其他特徵或步驟。 The word "preferred" in this article is non-exclusive and should be understood as "preferably but not limited to". order, the scope of the present invention should be determined only by the appended claims and their equivalents, not by the examples illustrated in the implementation; when the term "comprising" and its variations appear in the specification and claims, it is An open-ended term without a restrictive meaning that does not exclude other features or steps.
請同時參閱第2圖到第7B圖，其詳細揭示本發明方法之實施過程；本發明提出之積層製造(additive manufacturing,AM)方法，在資料前處理(data preprocessing)階段，首先由第一人員實施3D建模方法，包含一系列去雜訊、影像前處理、解剖學特徵辨識、解剖學特徵強化、對準、拼貼、內插、或者外插等前處理步驟，而重建針對完整或局部手術部位拍攝的多張二維平面醫學影像，建構出一個手術部位術前3D模型10之數位模型，二維平面醫學影像較佳為例如但不限於：X光影像、電腦斷層(CT)影像、錐狀射束電腦斷層(CBCT)影像、電腦斷層血管造影(CTA)影像、數位減影血管造影(DSA)影像、最大密度投影(MIP)影像、核磁共振影像(MRI)、或者核磁共振血管影像(MRA)等。
Please refer to Fig. 2 to Fig. 7B at the same time, which disclose the implementation process of the method of the present invention in detail; in the additive manufacturing (AM) method proposed by the present invention, in the data preprocessing (data preprocessing) stage, the first person first Implement 3D modeling methods, including a series of pre-processing steps such as denoising, image preprocessing, anatomical feature recognition, anatomical feature enhancement, alignment, tiling, interpolation, or extrapolation, and reconstruction is aimed at complete or partial A plurality of two-dimensional plane medical images taken at the surgical site are used to construct a digital model of the
第1A圖係揭示本發明實施例所應用之面部顴骨切削手術示 意圖；第1B圖係揭示本發明實施例所應用之面部顴骨切削手術所切削之L形顴骨片段之示意圖；本實施例係採面部整形之顴骨切削手術為例說明，以較具體說明本發明之實施，但本發明之實施不限於此等手術。 Fig. 1A shows the facial zygoma resection surgery applied in the embodiment of the present invention Intent; Fig. 1B is a schematic diagram showing the L-shaped zygomatic segment cut by the facial zygomatic cutting operation applied in the embodiment of the present invention; this embodiment is an example of the zygomatic cutting operation for facial plastic surgery, and will be described in more detail practice of the present invention, but the practice of the present invention is not limited to such procedures.
顴骨切削手術之目的在於顴骨內縮，故也稱顴骨內縮手術，主要是針對顴骨天生較為外張的病患，將其顴骨上較突出的部分切下，然後將切下的顴骨進行不同程度的內移，以善顴骨外張的問題，並改善病患的臉部輪廓。顴骨切割有多不同的切割方法，如依切口形狀區分，常見有I形切割(I-cut)、大L形切割(L-cut large)、L形切割(L-cut)、小L形切割(L-cut small)等。 The purpose of zygoma resection is to shrink the zygoma, so it is also called zygomatic reduction surgery. It is mainly for patients with naturally flared cheekbones. The zygomatic bone is moved in different degrees to solve the problem of zygomatic flare and improve the facial contour of the patient. There are many different cutting methods for cheekbone cutting. For example, according to the shape of the incision, there are I-cut, L-cut large, L-cut, and small L-cut. Cutting (L-cut small), etc.
如第1A圖與第1B圖所示，醫師將在病患之顴骨2上切割一個L形切口4以及一個I形切口6，以將顴骨2上較為突出的部分即切削部位8局部切削下來，然後將切削部位8稍微內推到預定位置後固定，術後可改變病患臉部輪廓，形成較為內縮的臉形，整個手術也稱為L形截骨術(L-shaped osteotomy)。
As shown in Figure 1A and Figure 1B, the doctor will cut an L-shaped
第2圖係揭示本發明之手術部位術前3D模型之示意圖；在本實施例，手術部位術前3D模型10較佳是一個病患頭部之局部頭部骨骼3D模型。製作完成的手術部位術前3D模型10將儲存在遠端之雲端伺服器之中，供該項目有存取權限的執刀醫師(surgeon)讀取使用，手術部位術前3D模型10也代表手術部位在手術前之狀態。
FIG. 2 is a schematic diagram showing the preoperative 3D model of the surgical site of the present invention; in this embodiment, the
接著，由醫師或第二人員，在本地端電腦設備上操作醫學影像處理平台，連結雲端伺服器以存取與下載手術部位術前3D模型10，準備進行術前(pre-operation)手術規劃，醫學影像處理平台之形式可以是在電腦
設備上執行之軟體程式，或透過網路瀏覽器(internet browser)提供給醫師在電腦設備上操作之雲端服務。
Then, the doctor or the second person operates the medical image processing platform on the local computer equipment, connects to the cloud server to access and download the
第3A圖係揭示本發明之手術部位術前3D模型上包含之手術面及切削部位之前視示意圖；第3B圖係揭示本發明之手術部位術前3D模型上包含之手術面及切削部位之立體透視示意圖；首先，醫師依照手術種類，在本實施例係為顴骨切削手術、同時衡量病患之需求、病患病況及與基本健康條件等進行手術規劃，判斷最適當的切口大小而決定手術面，即切口形狀或手術切削線。本發明所適用的手術種類涵蓋例如但不限於：骨折重建、整形削骨或L形截骨術(L-shaped osteotomy)，但本發明之實施不限於此等手術。 Figure 3A is a schematic diagram showing the front view of the surgical surface and the cutting site included in the preoperative 3D model of the surgical site of the present invention; Figure 3B is a three-dimensional view of the surgical site and the cutting site included in the preoperative 3D model of the surgical site of the present invention Perspective schematic diagram; firstly, the doctor decides the operation according to the type of operation, in this embodiment, the zygomatic resection operation, while considering the patient's needs, disease conditions and basic health conditions, etc., to determine the most appropriate incision size Surface, that is, the shape of the incision or the surgical cutting line. The types of operations applicable to the present invention include but not limited to: fracture reconstruction, osteotomy or L-shaped osteotomy, but the implementation of the present invention is not limited to these operations.
規劃過程包含調整手術面的位置大小、刪除手術面、調整手術面角度等，最終確定手術面11p以及相關手術參數，並標記在手術部位術前3D模型10之數位模型上，如第3A圖與第3B圖所示，醫師依經驗也可以標記多個不同形狀、大小、位置或角度的手術面11p供選擇。在本實施例，手術面11p之形狀較佳呈現L形，也就是第1A圖與第1B圖中的L形切口4，而手術面的位置與大小將決定L形切口4是大L形切割、L形切割或小L形切割等。
The planning process includes adjusting the position and size of the surgical surface, deleting the surgical surface, adjusting the angle of the surgical surface, etc., finally determining the
在顴骨切削手術中手術面11p較佳是一個切削面，但在不同手術種類中，手術面11p也可能是例如但不限於切削面或填補面等。當手術面11p後在手術部位術前3D模型10上確定後，預定切削部位20p也將隨之確定，如第3A圖與第3B圖所示。當醫師在手術部位術前3D模型10上完成手術面11p與預定切削部位20p之標定後，將已標記之手術部位術前3D模型10連同手術參數如手術面厚度等回傳雲端伺服器，或儲存到雲端伺服器上。
In the zygomatic surgery, the
第4A圖係揭示本發明之手術面3D模型之前視示意圖；第4B圖係揭示本發明之手術面3D模型之立體透視示意圖；再由第三人員在電腦設備上操作醫學影像處理平台執行以下步驟，首先參考已標記之手術部位術前3D模型10及手術參數，建立手術面3D模型11，如第4A圖與第4B圖所示。但值得注意的是，在外科手術中，手術面具有一定的厚度(thickness)或稱肉厚，是體積的概念而非無厚度之幾何平面。
Figure 4A is a schematic diagram of the front view of the 3D model of the surgical surface of the present invention; Figure 4B is a schematic perspective view of the 3D model of the surgical surface of the present invention; the third person operates the medical image processing platform on the computer equipment to perform the following steps First, referring to the marked
第5A圖係揭示本發明之切削部位3D模型之前視示意圖；第5B圖係揭示本發明之切削部位3D模型之立體透視示意圖；接著，由第四人員執行布林運算之交集運算(intersection operation)，根據手術面3D模型11之邊緣所涵蓋的範圍，從手術部位術前3D模型10上取出預定切削部位3D模型20，如第5A圖與第5B圖所示。在本實施例，預定切削部位3D模型20較佳就是第1A圖與第1B圖中的切削部位8，也是手術中預定將要內移的部位。
Fig. 5A is a schematic diagram of the front view of the 3D model of the cutting part of the present invention; Fig. 5B is a schematic perspective view of the 3D model of the cutting part of the present invention; then, the intersection operation (intersection operation) of the Boolean operation is performed by the fourth person According to the range covered by the edge of the surgical
第6A圖係揭示本發明之手術部位在手術過程中經過切削後之3D模型之前視示意圖；第6B圖係揭示本發明之手術部位在手術過程中經過切削後之3D模型之立體透視示意圖；接著，由第五人員執行布林運算之差集運算(difference operation)，根據預定切削部位3D模型20所排除的範圍，從手術部位術前3D模型10上移除預定切削部位3D模型20，而生成手術部位術中3D模型30，係用於呈現在手術過程中，當預定切削部位3D模型20從手術部位上切下後，手術部位的立體狀態，如第6A圖與第6B圖所示。在本實施例，手術面3D模型11較佳是包含在手術部位術中3D模型30上。
Figure 6A is a schematic front view showing the 3D model of the surgical site of the present invention after being cut during the operation; Figure 6B is a schematic perspective view showing the 3D model of the surgical site of the present invention after being cut during the operation; , the fifth person performs the difference operation of the Bollinger operation, and removes the
第7A圖係揭示經由實施本發明方法所製造之三維術前術後狀態多色全模型之前視示意圖與凹部與凸部之放大示意圖；第7B圖係揭示
經由實施本發明方法所製造之三維術前術後狀態多色全模型之立體透視示意圖與凹部與凸部之放大示意圖；由於手術過程中，所切下的切削部位8會需要進行內移以使顴骨較為內縮，因此，在本實施例，接著由第六人員參照第1A圖與第1B圖中I形切口6的位置，將位於鬢角處之I形切口6另以移動接點40的形式呈現，使得預定切削部位3D模型20將可以經由移動接點40而相對於手術部位術中3D模型30進行移動，以便醫師經由操作後續製造之實體3D模型進行切削部位8內移之模擬。
Fig. 7A is a schematic diagram of the front view and an enlarged schematic diagram of the concave and convex parts of the multi-color full model of the three-dimensional preoperative and postoperative state manufactured by implementing the method of the present invention; Fig. 7B is the disclosure
The three-dimensional perspective schematic diagram of the three-dimensional preoperative and postoperative state multicolor full model manufactured by implementing the method of the present invention and the enlarged schematic diagram of the concave part and the convex part; due to the operation process, the
因此第六人員分別在手術部位術中3D模型30與預定切削部位3D模型20上設計一個在位置上相互對應而結構幾何形狀係彼此互補的例如但不限於：矩形凸部(第一接點)31與矩形凹部(第二接點)21，以構成一個移動接點40，如第7A圖與第7B圖所示，並依照矩形凸部31與矩形凹部21之結構對應修改手術部位術中3D模型30與預定切削部位3D模型20。舉例來說，修改後的手術部位術中3D模型30將包含矩形凸部31，如第6A圖與第6B圖所示。而矩形凸部31與矩形凹部21的長軸即縱軸與水平面之間將包含一個小角度的夾角，此夾角將由切削部位8之內移角度而決定。
Therefore, the sixth person designs an
經由使手術部位術中3D模型30矩形凸部31與預定切削部位3D模型20矩形凹部21互相對準，可使得後續依照預定切削部位3D模型20所製造之實體3D模型，可以相對於依照手術部位術中3D模型30所製造之實體3D模型進行移動，以便醫師經由操作後續製造之實體3D模型進行切削部位8而進行不同深淺程度之內移之模擬。
By aligning the rectangular
大致上來說，手術面3D模型11較佳是包含在手術部位術中3D模型30上，預定切削部位3D模型20與手術部位術中3D模型30之組合將大
致等同於手術部位術前3D模型10，因此手術面3D模型11、預定切削部位3D模型20以及手術部位術中3D模型30將共同形成一組3D術前術後狀態多色全模型50，其中手術部位術前3D模型10、手術面3D模型11、預定切削部位3D模型20、手術部位術中3D模型30以及3D術前術後狀態多色全模型50皆可建置為單獨的獨立數位3D模型，並各自以相同或不同格式的電子檔案形式分開儲存，而檔案格式較佳為例如但不限於立體光刻(STereoLithography,STL)格式。
Generally speaking, the
接著進入實際製造階段，由第七人員，在本地端電腦設備上操作積層製造切層軟體，將手術面3D模型11、預定切削部位3D模型20以及手術部位術中3D模型30同時載入，並透過切層軟體規劃積層製造的分層結構與列印計畫，手術面3D模型11、預定切削部位3D模型20以及手術部位術中3D模型30將分別以第一材料、第二材料與第三材料製造，而第一材料、第二材料與第三材料較佳為相同或不同材料，具有相同或不同之材料性質，或具有相同或不同之顏色，或具有相同或不同之表面粗糙度。
Then it enters the actual manufacturing stage. The seventh person operates the lamination and slicing software on the local computer equipment to simultaneously load the
舉例來說，在本實施例，手術部位術中3D模型30將以具有第一顏色的第一材料來製造，例如但不限於白色生物相容性熱塑塑膠材料，而包含在手術部位術中3D模型30上的手術面3D模型11將以具有第二顏色的第二材料來製造，如紅色的生物相容性熱塑塑膠材料，而預定切削部位3D模型20將以具有第三顏色的第三材料來製造，如米色生物相容性熱塑塑膠材料。
For example, in this embodiment, the
當列印計畫完成後，第八人員在本地端電腦設備上透過操作積層製造切層軟體控制3D列印設備，在同一批次(the same batch)的積層製造
作業中，同時製造手術面3D模型11、預定切削部位3D模型20以及手術部位術中3D模型30，包含活動接頭40，從而製造出一個3D術前術後狀態多色全模型50之實體模型。
After the printing plan is completed, the eighth person controls the 3D printing equipment by operating the layering software on the local computer device, and performs the same batch of layering
During the operation, the
手術部位術中3D模型30上包含的矩形凸部31與矩形凹部21，能夠讓預定切削部位3D模型20相對於手術部位術中3D模型30為可移動，在顴骨切削手術中，可以讓醫師模擬各種不同的顴骨內推方案的可能效果，使病患正確認知手術效果，避免病患因錯誤認知而對手術結果產生不合理期待。
The rectangular
本發明包含的每一個3D模型，包含手術部位術前3D模型10、手術面3D模型11、預定切削部位3D模型20、手術部位術中3D模型30以及3D術前術後狀態多色全模型50等，都可以根據每位病患獨特的組織結構及手術過程，為病患客製化量身定做，且資料前處理階段與製造階段可以分別交由相同或不同人員分開操作執行，每一個步驟也可以分拆給相同或不同人員分開或合併執行。特別是手術面標記的步驟，可單獨分離由病患的執刀醫師進行，而其餘步驟另交由專業積層製造團隊執行。
Each 3D model included in the present invention includes a
透過3D術前術後狀態多色全模型50之單一實體模型，就可以呈現多重手術資訊，例如但不限於：明確且具體的展示出切削部位相對於術前部位或術後部位的準確位置與方向、以具有厚度的實體特徵呈現手術面(手術切削線)或切口形狀之實際情況供醫病溝通評估、交叉利用顏色材質差異呈現手術資訊、透過活動接頭的配置動態具體呈現手術效果、將術前與術後之差異性同時呈現於單一3D實體模型上等等。
Through the single physical model of the 3D multicolor
因此醫師只需透過向病患展示所製造的3D術前術後狀態多
色全模型50之實體模型，就可以清晰又明確的向一般無醫學背景病患具像化(representationalized)展示各種原本複雜晦澀的手術資訊，讓病患能以直觀的方式瞭解相關手術資訊，並清楚了解自身的醫療處置方案，及術前及術後的差異性，尤其讓病患具體正確認知手術成效，進而產生合理之期待，將有效促進醫病溝通順暢。
Therefore, doctors only need to show patients the 3D preoperative and postoperative status.
The physical model of the color
如此一來，本發明提出之積層製造方法，藉由3D術前術後狀態多色全模型50將術前及術後之差異性呈現於單一3D模型上，令病患及醫師可於術前充分溝通並瞭解術前及術後差異性，使術後預期效果控制在最佳範圍內，而在同一批次製程中製造三維術前術後狀態多色全模型，將明顯縮短製程時間，有利快速製造並簡化製造步驟，適合多樣化但少量之客製化製造之大規模系統化實施，或作為商業模式實施。
In this way, the multi-color
第8圖揭示本發明同批次製造三維術前術後狀態多色全模型積層製造方法之實施步驟流程圖；小結而言，本發明同批次製造三維術前術後狀態多色全模型積層製造方法100，較佳包含但不限於下列步驟：由第一人員實施三維建模技術將複數二維醫學影像重建為該手術部位術前三維模型(步驟101)；由第二人員在該手術部位術前三維模型上標記該手術面(步驟102)；由第三人員基於該手術面建立該手術面三維模型(步驟103)；由第四人員實施交集運算以根據該手術面從該手術部位術前三維模型上獲得該切削部位三維模型(步驟104)；由第五人員實施差集運算以根據從該手術部位術前三維模型上移除該切削部位三維模型獲得該手術部位術中三維模型(步驟105)；由第六人員修改該手術部位術中三維模型與該切削部位三維模型，以分別在該手術部位術中三維模型與該切削部位三維模型中形成第一
接點與第二接點(步驟106)；由第七人員根據該手術部位術中三維模型、該手術面三維模型與該切削部位三維模型規劃切層路徑生成計畫(步驟107)；以及由第八人員實施該積層製造並在同一批次製程中製造包含該手術部位術中三維模型、該手術面三維模型與該切削部位三維模型之三維術前術後狀態全模型(步驟108)。
Figure 8 reveals the flow chart of the implementation steps of the multi-color full model lamination manufacturing method of the present invention in the same batch for manufacturing the three-dimensional pre-operative and post-operative states; The
本發明以上各實施例彼此之間可以任意組合或者替換，從而衍生更多之實施態樣，但皆不脫本發明所欲保護之範圍，茲進一步提供更多本發明實施例如次： The above embodiments of the present invention can be arbitrarily combined or replaced with each other, thereby deriving more implementation forms, but none of them depart from the scope of protection intended by the present invention. More embodiments of the present invention are further provided as follows:
實施例1：一種積層製造方法，其包含：在手術部位術前三維模型上標記手術面並據此建立手術面三維模型；實施布林運算以根據該手術面從該手術部位術前三維模型上獲得切削部位三維模型，以及從該手術部位術前三維模型上移除該切削部位三維模型獲得手術部位術中三維模型；以及實施積層製造並在同一批次製程中製造包含該手術部位術中三維模型、該手術面三維模型與該切削部位三維模型之三維術前術後狀態多色全模型之實體模型。 Embodiment 1: A kind of additive manufacturing method, it comprises: mark the surgical surface on the preoperative three-dimensional model of the surgical site and establish the three-dimensional model of the surgical surface accordingly; obtaining a three-dimensional model of the cutting site, and removing the three-dimensional model of the cutting site from the preoperative three-dimensional model of the surgical site to obtain an intraoperative three-dimensional model of the surgical site; The three-dimensional model of the surgical surface and the solid model of the multi-color full model of the three-dimensional preoperative and postoperative state of the three-dimensional model of the cutting site.
實施例2：如實施例1所述之積層製造方法，還包含以下其中之一：由第一人員實施三維建模技術將複數二維醫學影像重建為該手術部位術前三維模型；由第二人員在該手術部位術前三維模型上標記該手術面；由第三人員依據該手術面建立該手術面三維模型；由第四人員實施交集運算以根據該手術面從該手術部位術前三維模型上獲得該切削部位三維模型；由第五人員實施差集運算以根據從該手術部位術前三維模型上移除該切削部位三維模型獲得該手術部位術中三維模型；由第六人員修改該手 術部位術中三維模型與該切削部位三維模型，以分別在該手術部位術中三維模型與該切削部位三維模型中形成第一接點與第二接點以形成移動接點；由第七人員根據該手術部位術中三維模型、該手術面三維模型與該切削部位三維模型規劃切層路徑生成計畫；以及由第八人員實施該積層製造並在同一批次製程中製造包含該手術部位術中三維模型、該手術面三維模型與該切削部位三維模型之三維術前術後狀態多色全模型。 Embodiment 2: The additive manufacturing method as described in Embodiment 1, further comprising one of the following: the first person implements three-dimensional modeling technology to reconstruct the complex two-dimensional medical images into a preoperative three-dimensional model of the surgical site; Two people mark the surgical surface on the preoperative 3D model of the surgical site; the third person builds the 3D model of the surgical surface based on the surgical surface; The three-dimensional model of the cutting site is obtained on the model; the fifth person implements the subtraction operation to obtain the intraoperative three-dimensional model of the surgical site by removing the three-dimensional model of the cutting site from the preoperative three-dimensional model of the surgical site; the sixth person modifies the manual Intraoperative three-dimensional model of the surgical site and the three-dimensional model of the cutting site to form a first joint and a second joint in the three-dimensional model of the surgical site and the three-dimensional model of the cutting site respectively to form a moving joint; the seventh person according to the The intraoperative three-dimensional model of the surgical site, the three-dimensional model of the surgical surface, and the planning slice path generation plan of the three-dimensional model of the cutting site; and the eighth person implements the additive manufacturing and manufactures the intraoperative three-dimensional model of the surgical site, The three-dimensional model of the surgical surface and the three-dimensional model of the cutting site are multi-color full models of the three-dimensional preoperative and postoperative states.
實施例3：如實施例2所述之積層製造方法，其中該等二維醫學影像係選自X光影像、電腦斷層(CT)影像、錐狀射束電腦斷層(CBCT)影像、電腦斷層血管造影(CTA)影像、數位減影血管造影(DSA)影像、最大密度投影(MIP)影像、核磁共振影像(MRI)以及核磁共振血管影像(MRA)或其組合其中之一。
Embodiment 3: The laminated manufacturing method as described in
實施例4：如實施例2所述之積層製造方法，其中該第一人員、該第二人員、該第三人員、該第四人員、該第五人員、該第六人員、該第七人員與該第八人員係為同一人或者不同一人。
Embodiment 4: The additive manufacturing method as described in
實施例5：如實施例2所述之積層製造方法，其中該第一接點與該第二接點之結構幾何形狀為互補，當該第一接點與該第二接點對準後，該手術部位術中三維模型與該切削部位三維模型之對應實體將透過該移動接點以可移動之方式組合在一起，使得該切削部位三維模型之實體模型能相對於該手術部位術中三維模型之實體模型進行移動。
Embodiment 5: The build-up manufacturing method as described in
實施例6：如實施例2所述之積層製造方法，其中該第一接點與該第二接點分別為凸部與凹部。
Embodiment 6: The build-up manufacturing method as described in
實施例7：如實施例1所述之積層製造方法，其中該三維術前 術後狀態多色全模型之實體模型能將術前與術後之差異性同時呈現。 Embodiment 7: The additive manufacturing method as described in Embodiment 1, wherein the three-dimensional preoperative The physical model of the multi-color full model of the postoperative state can present the differences between preoperative and postoperative at the same time.
實施例8：如實施例1所述之積層製造方法，其中該手術部位術中三維模型、該手術面三維模型與該切削部位三維模型係分別以第一材料、第二材料與第三材料製造。 Embodiment 8: The additive manufacturing method as described in Embodiment 1, wherein the intraoperative three-dimensional model of the surgical site, the three-dimensional model of the surgical surface, and the three-dimensional model of the cutting site are manufactured with the first material, the second material, and the third material, respectively.
實施例9：如實施例8所述之積層製造方法，其中該第一材料、該第二材料與該第三材料係為相同或者不同材料。
Embodiment 9: The build-up manufacturing method as described in
實施例10：如實施例8所述之積層製造方法，其中該第一材料、該第二材料與該第三材料係為相同顏色或者不同顏色之材料。
Embodiment 10: The laminated manufacturing method as described in
本發明各實施例彼此之間可以任意組合或者替換，從而衍生更多之實施態樣，但皆不脫本發明所欲保護之範圍，本發明保護範圍之界定，悉以本發明申請專利範圍所記載者為準。 The various embodiments of the present invention can be combined or replaced arbitrarily with each other, thereby deriving more implementation forms, but none of them depart from the intended protection scope of the present invention, and the definition of the protection scope of the present invention is fully defined by the patent scope of the present invention application The recorder shall prevail.
100:同批次製造三維術前術後狀態多色全模型積層製造方法 100: Multi-color full model lamination manufacturing method for manufacturing 3D preoperative and postoperative states in the same batch
101~108:實施步驟 101~108: Implementation steps
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| CN104739513A (en) * | 2015-03-12 | 2015-07-01 | 徐贵升 | Method for producing human tissue simulated operation model and guide plate |
| US20190021865A1 (en) * | 2016-02-17 | 2019-01-24 | Koninklijke Philips N.V. | Physical 3d anatomical structure model fabrication |
| CN110706825A (en) * | 2019-10-24 | 2020-01-17 | 陈�峰 | Orthopedic medical platform system and method based on three-dimensional modeling and 3D printing |
| TW202210040A (en) * | 2020-09-02 | 2022-03-16 | 台灣骨王生技股份有限公司 | Orthopedic surgery assistant planning method and system including a three-dimensional space model building step, a skeleton displaying step, an information input step, and a three-dimensional customized bone plate creation step |
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| CN104739513A (en) * | 2015-03-12 | 2015-07-01 | 徐贵升 | Method for producing human tissue simulated operation model and guide plate |
| US20190021865A1 (en) * | 2016-02-17 | 2019-01-24 | Koninklijke Philips N.V. | Physical 3d anatomical structure model fabrication |
| CN110706825A (en) * | 2019-10-24 | 2020-01-17 | 陈�峰 | Orthopedic medical platform system and method based on three-dimensional modeling and 3D printing |
| TW202210040A (en) * | 2020-09-02 | 2022-03-16 | 台灣骨王生技股份有限公司 | Orthopedic surgery assistant planning method and system including a three-dimensional space model building step, a skeleton displaying step, an information input step, and a three-dimensional customized bone plate creation step |
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