Case study – implantation of Codubix® 3D cranial prosthesis 2
Matopat Representative – Lithuania
1. Place – Kaunas (Lithuania)
Location of the operation:
Public facility, Lithuanian University Hospital of Health Sciences in Kaunas.
The clinic is the largest multi-profile hospital in Lithuania, and one of the most modern in the country.
The hospital employs more than a thousand doctors and more than two thousand medical personnel. The hospital can simultaneously accommodate up to two thousand patients. In fifteen buildings there are 34 profiled clinics, and 15 outpatient departments.
Date of the operation: 26/04/2013
2. Situation / circumstances
In January 2013 I conducted a presentation for neurosurgeons on Codubix® products. I presented all the possibilities and benefits they offer.
About two months later, I received a call from the hospital. They had a patient who needed the individual prosthesis.
The patient had a gunshot wound in the skull. The patient lost a large part of the skull (photos below). For about a month the doctors fought for his life. After a month it was necessary to restore the damaged bone. The product, which was available in the hospital – Tecres s.p.a Acrilic resin – was not suitable for such a serious damage. It was decided to prepare an individual prosthesis.
Once again I had to present all the possibilities of preparing the individual prosthesis.
3. Actions before the operation
On March 29, 2013 under my direction all the necessary computer images were taken and transferred to the Tricomed company. There began the production of the prosthesis.
Typical prosthesis Maximum size of the prosthesis Prosthesis needed for the given patient
Because the damage was very serious, the producer decided to make the prosthesis in two parts.
Dr. P. Kasprzak explains – the largest prosthesis met in the literature was 400 cm2. In our case – 280 cm2. It is the second largest case in the world (of course of the known cases).
April 25, 2013 I received the individually prepared prosthesis.
4. Course of the operation
The operation took place on April 26, 2013. I took part in it.
The operation was conducted by two doctors:
1. Associate Professor R. Vilcinis – head of the Craniocerebral Department
2. L. Kalasauskas MD – patient’s doctor
The operation lasted for about three hours. The adjustment of the prosthesis Codubix® 3D took about 30 minutes. Parts of the prosthesis were connected by means of Aesculap titanium plates. Using the same Aesculap titanium plates the prosthesis was attached to the skull.
during the operation
preparing the place for the implant
after the implantation
before and after the operation
5. Time after the surgery
The patient’s condition is stable, there is no visible signs of possible complications. The patient is transferred to the general neurosurgery ward.
The patient’s condition is stable, there is no signs of complications.
The patient’s condition is stable. The neurological condition improved – the patient began to respond to the environment, he began to move his legs and his fingers. From time to time there was a smile on his face.
6. Doctor’s evaluation
The Head of the Department and the patient’s doctor were very satisfied with the results. The prepared prosthesis made very good impression on them – it was of good quality, precise, easily adjustable. Such a large skull bone loss (a gunshot wound) could only be completed with an individually prepared prosthesis.
7. Problems / remarks
The hospital is very demanding as for the manufacturers and product representatives. Therefore, it took a lot of effort to get doctors to make a positive decision. This result was achieved only by working closely with the company employees and their operability.