ACCISS: Complex Surgical Solutions

Translational Research

Translating complex surgery into innovative solutions

ACCISS is a recently translated service in the Division of Surgery at the Princess Alexandra Hospital.

ACCISS provides both a physical and virtual surgical planning service using 3D printing, virtual and augmented reality technologies to improve clinical outcomes and collaborates with healthcare providers and academic partners to develop and test new medical device technology that is still emerging in clinical trials.

ACCISS supports clinicians to access and utilise new and emerging technologies through:

constructing 3D virtual images from standard imaging modalities
design and development of physical reference anatomical biomodels at the point of care
visualisation of complex pathology and surgical complications
custom-made cutting guides, surgical tools and a wide range of assistive medical tools

Specialist Expertise

As one of only a very small number of providers in Australia and New Zealand producing 3D modelling and medical devices within a clinically acceptable timeframe, ACCISS has been assisting with complex surgical cases since 2018.

Since that time, they have matured into the most sophisticated and experienced clinically integrated PoC PMD facility in Queensland, providing this service to individual clinicians and clinical teams within the local tertiary public hospital system.

Capabilities

Our additive manufacturing workflows include fused deposition moulding/modelling (FDM) – used in surgical planning and patient eduction; and Stereolithography (SLA) resin printing – required for surgical guides, jigs and cement moulds designed to produce patient-matched joint spacers and cranioplasty implants.

FMD printed models are generally required for surgical planning and patient education
Resin printed models are required for surgical guides, jigs and cement moulds designed to produce patient-matched joint spacers and cranioplasty implants

Patient-matched device technology

The medical devices designed and manufactured at ACCISS are created using patient MRI or CT scan files. Software merges scans together to create a 3D image which can then be annotated and manipulated to enable virtual viewing of each anatomical structure in isolation and in conjunction with other bony and soft tissue structures and organ systems. The virtual model is then used to design scaffolding for 3D printing, enabling the lead clinician to better conceptualise the problem and plan a more effective solution.

Target Populations

ACCISS technology is able to be utilised in complex surgical planning cases across a range of specialties.

In addition, ACCISS are working on a referral base for patient-matched anatomical biomodels for the purpose of surgical correction and repair to be used by consultants, fellows, registrars and pre-trainees.

This library of biomodels can also be used in outpatient clinics to demonstrate the pathology to patients and their carers, as well as the surgical approach to be undertaken including the risks and benefits.

Specialties include:

Plastic and Reconstructive Surgery (PRS)
orthopaedics
anaesthetics
paediatric cardiothoracic surgery
neurosurgery
maxillofacial
craniofacial
orthodontics and prosthodontics
spine
vascular
malformations clinic
general surgery

Remote Virtual Solutions

ACCISS regularly receives referrals from external public and private centres to provide virtual and pre-operative surgical planning services.

Our services are able to be replicated via virtual integration to support a diversity of clinical teams in more remote and regional areas and it is our objective to be able to support a diversity of clinical teams via a ‘hub and spoke’ healthcare model.

Meet Dr Michael Wagels

Director, ACCISS

Dr Michael Wagels is the Director of Australian Centre for Complex Integrated Surgical Solutions (ACCISS) and Clinical Director of Herston Biofabrication Institute (HBI). The two Institutions deliver clinically applied digital innovations for clinical and research use. Michael is a Staff Specialist Plastic and Reconstructive Surgeon at Metro North Health and Metro South Health.

Michael’s area of clinical interest is complex reconstruction of the peripheral nervous system, hand, and craniofacial skeleton. He is also interested in the translational aspects of tissue engineering for complex reconstructive defects. These present clinical problems that sometimes may only be solved with patient-matched and custom-made medical devices.

Michael has undertaken three first in human trials of patient specific bioresorbable implants using Regenerative Matching Axial Vascularisation. These complex cases involved large volume bone defects in axial and load-bearing appendicular bone as well as soft tissue contour deformity. They are the impetus for clinical trials of patient specific bioresorbable implants in long segment tibial defects, skull reconstruction and camouflage correction of pectus excavatum.