| BackgroundThe penis is male genesis and secondary sex characteristic organ. It has been attendedby medical correlating specialties and men themselves for long time. The penis restoration isthe most challenging problem in generative organ defect. Especially in recent years, alongwith rapid development of national economy and improvement of material lifestandard, people increasingly pursue esthetical body, and the penis minor malformationgradually increases in clinic.The penis minor malformation mainly caused by inborn cacoepy, surgical traumadefect, tumor of penis ablatio or scar abnormity of perineal position burning. Since1970s, Kelly and Eraklis firstly performed penis lengthening method that cavernous bodypeduncle was separated from pubis, a rapid progress for diagnosis and treatment of thepenis minor malformation has been performed under the advance development ofassociated techniques such as radiological technique, CAD technique. The penis possessed acomplicated anatomical structures, in which the penis required an accurate adjustment andfunction maintenance in order to avoid penis deformity and suffering.Recent the Scholars established many methods to penis plasty, but these techniqueslacked that the penis structure were all reconstructed, displayed jointly and measuredconveniently. So prolong length could not evaluate exactly, and normal physiologic functioncould not ensured, and complication could not avoided, such as edema, nerve injury,dysfunction, and so on. Whereas, without individual penis reconstruction, there was toodifficulties to obtain a normal position and satisfying effect, the treatment result was alsounpredictable. These problems need badly solved in penis plasty.This research consisted five parts as follow:1. To build digitized visible model of the adult penis and adjacent structure of theChinese visible human. Providing morphological data for plastic plerosis of external genitals diagnosis and the adult penis surgery planning. Cross-sectional images of fleshtissues from the Chinese visible human dataset and the visible penis and adjacent structuredataset were reviewed and the structures of the penis and adjacent structure were confirmedon a section-by-section basis. Three-dimensional computer reconstructions of the penis andadjacent structure were generated from these data by surface rendering.2. Based on the theory of digital anatomy, introduce to obtain soft tissues 3D dataaccurately to use 3D scanner under the condition of non-contact. To exploit the software forrapid measurement, analysis and diagnosis in penis plasty. We use reverse engineeringcollected and reconstructed penis shape, and to provide data sources for buliding individualtypical model and 3D operation simulation.3. To analyze 3D digitized image of the adult penis, providing morphological data forplastic plerosis of the adult penis diagnosis and the surgery planning. 200 adult penis weremeasured length and perimeter of the resting state and erection, and analyzed relation of theerectile angle and length, perimeter by the Angel Digital Image Studio software. Itelucidated the way of 3D standard measuring in clinic of plastic surgery.4. To fabricate penis models, implants and performed penis model surgery withapplication of Computer Assisted Design/Computer Assisted Manufacture(CAD/CAM)technique and to study the individual reconstruction on patients with penis minormalformation. The men was placed on a helical CT scanner table. The CT data acquisitionwas performed a 1 mm section thickness in spiral mode. Adjustment of threshold value andstacking the segment with pels, we obtained an approximated 3D visual model of thescanned penis using Magic 9.0 software. An penis and adjacent structure RP model basedon the dataset of the 3D visual model was fabricated by RP machine.5. To investigate virtual surgery of the restitution of penis in a 3D virtual environment.To formulate quantify of preoperative operation planning and to objective evaluate ofcurative effect after operation. Three-dimensional computer reconstructions of the adultpenis and adjacent structure were generated and the reconstructive virtual surgery of peniswere operated on Intel Pentiumâ…£computer.Results1. The quality of the computerized 3D-reconstructed images was distinct and perfect.The adult penis and adjacent structure were all reconstructed and displayed jointly. All reconstructed structures can be represented individually or jointly any diameter and angleof the structures reconstructed could be measured conveniently.2. 200 adult men performed 3D scanning, and 3D penis digital model was then built. Itis a datebase according to name arranged.3. Using Angel Digital Image Studio Soft the rapid diagnosis system, there are notdifference in measurement between manual and software, but it can improve 34-36 times inspeed using the software. We get a penis diagnosis in five minutes was come true. With theage and stature growing, penile is becoming increase, stature and length did not form directratio. With the erectile angle increasing, penile hardness is becoming strong, but penilevolume do not marked change.4. The penis and adjacent structure RP model has been successfully manufactured. Itcan display penis, scrotum, testis, cavernous body, cavernous body of urethra and adjacentstructure of bladder, rectum, hip bone and so on with 3D digital images, which are vivid andvisual. Fibrous connective tissue and bone tissue marked with different color, and displayedcontinuely, and resolved accuratly disposition condition.5. In a 3D virtual environment, the plastic and reconstructive virtual surgery of adultpenis were simulated and quantify operating plan were formulated.Conclusion1. The digitized model of the penis and adjacent structure offer unique insights into thecomplex penis anatomy, providing morphological data for plastic plerosis of externalgenitals diagnosis and surgery planning.2. Our studies increased metered latitude of shape. It maked up a deficiency of penis indata measurement. Following 3D scanner improved accurately, the complicated contour ofpenis was comed true, and expanded medical treatment visual field, and decreased operatingblind zone.3. The digitized model of the penis and adjacent structure offer unique insights into thecomplex penis anatomy, providing morphological data for Preoperative design andpostoperative effective evaluation of the penile plastic plerosis.4. Our studies established accuratly and reliable for identity 3D penis model. Itidentified 3D stereo structure of penis importance. Reverse engineering technology appliedin penis plasty was come true successfully. It improved curative effect of penis restitution. 5. The research can provide a new method of the virtual surgery in the plastic andreconstructive of adult penis,such as quantify operating design,selecting the best operativeroute and curative effecting evaluation after operation.It can provide a new means,forexample the plastic surgery teaching training,more subjects consultation and long rangeinterview.
|
PDF Full Text Request