Intraoperative three‐dimensional scanning of head and neck surgical defects: Enhanced communication and documentation of harvested supplemental margins

Abstract

BackgroundWe have demonstrated the effectiveness of 3D resection specimen scanning for communicating margin results. We now address the corresponding surgical defect by debuting 3D defect models, which allow for accurate annotations of harvested supplemental margins.MethodsSurgical defects were rendered into 3D models, which were annotated to document the precise location of harvested supplemental margins. 3D defect scans were also compared with routine 2D photography and were analyzed for quality, clarity, and the time required to complete the scan.ResultsForty defects were scanned from procedures including segmental mandibulectomy, maxillectomy, and laryngopharyngectomy. Average duration of defect scan was 6 min, 45 s. In six of ten 2D photographs, the surgeon was unable to precisely annotate the extent of at least one supplemental margin.Conclusion3D defect scanning offers advantages in that this technique enables documentation of the precise location and breadth of supplemental margins harvested to address margins at‐risk.

Reimagining Pathology Reporting for Head and Neck Cancer Resections: 3D Visualizations and Margin Reconciliation

“…We have previously described our work ow for 3D specimen scanning [5,12,13]. The complexity of large head and neck resections render them di cult to document, either by drawing or descriptions.…”

“…Following videoconferencing to describe the margin results, the surgeon annotates 3D defect scans to document location and size of harvested supplemental margins. We have previously demonstrated that 3D defect scans are superior to standard conventional defect photography, as the defect scans are rotated in space to optimize documentation of supplemental margins [12].…”

“…The 3D specimen representations are annotated with the location of all histologically sampled margins and the pathology results. 3D scanning of the surgical defect allows surgeons to accurately document the locations and breadth of supplemental margins that address margins at-risk [12]. Our previously published "frozen section timeout form" connects these two processes and transparently documents that the intraoperative margin status has been discussed, understood, and addressed [13].…”

“…We surveyed multidisciplinary stakeholders to determine how to improve resection margin reporting and identi ed a unique opportunity for enhancing reporting of complex head and neck cancer resections. We provide enhanced visuospatial documentation of the resection specimen, surgical defect, and nal surgical margin status by generating mixed-media pathology reports that include screen shots from digitally annotated 3D resection specimen and defect models [5,12,13]. Given the above advances in intraoperative communication on margin surveillance, it is clear that there is room for innovation in permanent surgical pathology reporting.…”