Captain Saar Ganor, an Armored Corps officer from Moshav Regba, was injured in one of the hardest battles at the beginning of the war in Gaza. He was hit by an explosion which caused serious head injuries. When he arrived at Soroka Medical Center, it turned out that he was suffering from a fractured skull and a serious injury to his left eye socket, which led to the loss of it.
Dr. Michael Pesis, an oral and maxillofacial surgeon at Soroka who carried out the highly complex facial reconstruction surgery, told Ynet about the advanced technology used in the procedure, and how after all these surgeries, Saar can now smile.
Saar Ganor enlisted in reserve duty on October 7. He was seriously wounded in the battle of Khan Younis in December by an anti-tank missile and was airlifted to the trauma room in Soroka. Upon his arrival, extensive examinations revealed the severity of his injuries: severe head trauma, crushed skull and facial fractures and a severe injury to his left eye, in addition to numerous orthopedic injuries. Immediate emergency surgery was necessary to relieve the pressure that had built up inside his skull due to internal bleeding and bone fragments.
"Saar came to us with a severe, multi-system injury. He arrived at the emergency room and was treated for all of his injuries for initial stabilization of his condition and life-saving surgery. In one of the first surgeries, we from the oral and maxillofacial department came in with our colleagues from neurosurgery, and during the surgery, his skull was removed to stabilize his critical condition," says Dr. Pesis.
"Beyond the issue of a portion of the skull being intentionally removed, we had to leave the parts of his face that had sustained very severe injuries. We did everything possible to assemble his face from this complex puzzle of very small, broken and scattered bones in every direction. What could be stabilized and kept in place, we did, connecting with titanium plates that hold everything in place. That's how we essentially released Saar for further treatment until his condition improved, until we could perform more complex surgeries," explains Dr. Pesis.
When Saar underwent a series of treatments and a long rehabilitation process at the Levinstein Hospital, the doctors at Soroka began planning the reconstruction itself. "We used a familiar technology in the field of neurosurgery, but it was used for the first time in Israel to reconstruct part of the face and eye socket that were severely damaged. It is essentially an advanced 3D technology in which we take the patient's old CT scans, do a 3D reconstruction of them and then build the model."
The implants were specially designed and made of an advanced polyethylene material called SU-POR, which allows for an extremely precise and durable reconstruction. The implant was designed and printed using 3D technology by an American company called Poriferous. "We had a lot of meetings with the engineers of the American company, we planned every detail down to the millimeter," said Dr. Pesis.
Dr. Michael Pesis: "I will never forget the moment I walked in the day after the surgery. I saw Saar for a long time, I accompanied him and his family, I saw the feeling on his face, the difficult expressions on his face, and when he saw me for the first time after the surgery, when he smiled and raised his hand to say 'hi', it melted me."
He explained exactly how the reconstruction was performed: "What we do is, we take the uninjured side and do 'mirroring' - a mirror image and transfer it to the injured side. This way, we reverse and build two identical sides, so to speak. The part that is missing, which is injured, we complete with the part from the other, uninjured side of the patient, and then we build the same implant for ourselves. This material was chosen to avoid surgeries on other areas of Saar's body to harvest donor bones and use the most advanced technologies available in medicine today."
According to Dr. Pesis, "In very rare cases, there are complications of infections or exposure of these implants, and then it is necessary to make repairs or remove and replace them. When this implant is not made of titanium, it is made of a material called porous polyethylene, a material that does not transmit heat or cold. So compared to the large implants that were used in the past, there were cases where people felt the temperature changes outside on their bodies. Today, this does not happen."
Saar's complex surgery involved a multidisciplinary team led by the director of the Department of Neurosurgery, Prof. Israel Melamed, and director of the Oral and Maxillofacial Unit at Soroka, Dr. Navot Givol, together with Dr. Michael Pesis, deputy director of the Department of Neurosurgery, Dr. Yuval Sofro, the anesthesia team and head of the operating room nursing team, Gali Sagi.
With the end of the surgery and the second phase of rehabilitation, Saar returned to an almost normal life. The journey was not easy, and included pain and difficulties, but perseverance, willpower and the support of the medical team allowed him to overcome the obstacles.
Dr. Pesis: "Of course, some of the nerves in his face that were damaged in his injury will unfortunately remain that way, but most of his expressions have returned to normal. However, there is more work ahead of us, there are more treatments that Saar needs to undergo, such as cosmetic and plastic treatments, so that his face will look better."
He excitedly says that Saar can now smile. "I will never forget the moment I walked in the day after the surgery. I saw Saar for a long time, I accompanied him and his family, I saw the feeling on his face, the difficult expressions on his face, and when he saw me for the first time after the surgery, when he smiled and raised his hand to say 'hi', it melted me."
According to Dr. Pesis, the surgery and the use of technology are not exceptional in global terms, but they certainly put Israel at the technological forefront. "Just last year I returned from a fellow's training in Basel, Switzerland, at one of the world's leading medical centers in the field, and following that I imported it to Soroka and the doctors are implementing the things I learned there and building a 3D lab.
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"Today, with our engineers and team members, we are already able to build and design these implants in-house. We are working with Israeli and international companies to print these models and optimize these models. We are bringing medicine into the future."