Preoperative Personalised Surgical Planning for Patient Undergoing Spiral Intestinal Lengthening and Tailoring: A Mathematical Approach

Autologous gastrointestinal surgical procedures are an important surgical tool for patient suffering SBS. However, these surgical procedures need extensive experience due to the limited number of cases and their high risk of complications. Despite LILT and STEP have developed large experience, SILT has been proposed only in the recent years and no long term follow up is still reported so far. One of the key characteristics of SILT is the longitudinally elongation of intestine by sliding one flap over the other using a spiral incision of the intestinal wall. At the present time, the SILT spiral incision seems to be influenced by surgical experience in AGIR, making this procedure very difficult to reproduce safely. To overtake this limit, we developed and validated a mathematical model, tailored on patient’s specific anatomical data, which aims to help the surgeon in defining the optimal incisions to perform SILT. Using this mathematical preoperative model, it is possible to predict the final shape of selected intestinal segment. Such tool can assist the physician in surgery room, improving the procedure and reducing surgical times.