Daniel Fritz Zweifel1, Christian Simon2, Remy Hoarau3, Philippe Pasche4, Martin Broome5. 1. Consultant, Maxillofacial Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Electronic address: daniel.zweifel@chuv.ch. 2. Chief Consultant, Ear-Nose and Throat Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 3. Consultant, Maxillofacial Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 4. Consultant, Ear-Nose and Throat Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. 5. Chief Consultant, Maxillofacial Surgery Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Abstract
PURPOSE: Virtual planning and guided surgery with or without prebent or milled plates are becoming more and more common for mandibular reconstruction with fibular free flaps (FFFs). Although this excellent surgical option is being used more widely, the question of the additional cost of planning and cutting-guide production has to be discussed. In capped payment systems such additional costs have to be offset by other savings if there are no special provisions for extra funding. Our study was designed to determine whether using virtual planning and guided surgery resulted in time saved during surgery and whether this time gain resulted in self-funding of such planning through the time saved. MATERIALS AND METHODS: All consecutive cases of FFF surgery were evaluated during a 2-year period. Institutional data were used to determine the price of 1 minute of operative time. The time for fibula molding, plate adaptation, and insetting was recorded. RESULTS: During the defined period, we performed 20 mandibular reconstructions using FFFs, 9 with virtual planning and guided surgery and 11 freehand cases. One minute of operative time was calculated to cost US $47.50. Multiplying this number by the time saved, we found that the additional cost of virtual planning was reduced from US $5,098 to US $1,231.50 with a prebent plate and from US $6,980 to US $3,113.50 for a milled plate. CONCLUSIONS: Even in capped health care systems, virtual planning and guided surgery including prebent or milled plates are financially viable.
PURPOSE: Virtual planning and guided surgery with or without prebent or milled plates are becoming more and more common for mandibular reconstruction with fibular free flaps (FFFs). Although this excellent surgical option is being used more widely, the question of the additional cost of planning and cutting-guide production has to be discussed. In capped payment systems such additional costs have to be offset by other savings if there are no special provisions for extra funding. Our study was designed to determine whether using virtual planning and guided surgery resulted in time saved during surgery and whether this time gain resulted in self-funding of such planning through the time saved. MATERIALS AND METHODS: All consecutive cases of FFF surgery were evaluated during a 2-year period. Institutional data were used to determine the price of 1 minute of operative time. The time for fibula molding, plate adaptation, and insetting was recorded. RESULTS: During the defined period, we performed 20 mandibular reconstructions using FFFs, 9 with virtual planning and guided surgery and 11 freehand cases. One minute of operative time was calculated to cost US $47.50. Multiplying this number by the time saved, we found that the additional cost of virtual planning was reduced from US $5,098 to US $1,231.50 with a prebent plate and from US $6,980 to US $3,113.50 for a milled plate. CONCLUSIONS: Even in capped health care systems, virtual planning and guided surgery including prebent or milled plates are financially viable.
Authors: Tsung-Yen Hsieh; Mena Said; Raj D Dedhia; Mary Roz Timbang; Toby O Steele; Edward Bradley Strong Journal: Craniomaxillofac Trauma Reconstr Date: 2020-05-05
Authors: Derek L Vanhille; Guilherme J M Garcia; Onur Asan; Azadeh A T Borojeni; Dennis O Frank-Ito; Julia S Kimbell; Sachin S Pawar; John S Rhee Journal: JAMA Facial Plast Surg Date: 2018-01-01 Impact factor: 4.611
Authors: Andreas Pabst; Elisabeth Goetze; Daniel G E Thiem; Alexander K Bartella; Lukas Seifert; Fabian M Beiglboeck; Juliane Kröplin; Jürgen Hoffmann; Alexander-N Zeller Journal: Clin Oral Investig Date: 2021-07-19 Impact factor: 3.573
Authors: Pontus Olsson; Fredrik Nysjö; Andrés Rodríguez-Lorenzo; Andreas Thor; Jan-Michaél Hirsch; Ingrid B Carlbom Journal: Plast Reconstr Surg Glob Open Date: 2015-08-10