This guide shows you how to find your way around the CustoMED Editor and Viewer: the views, the controls, the side panel and how your work is saved. It is for anyone who reviews or plans cases, so you know how the editor behaves before you make planning decisions.
Layout at a glance
The numbers in the screenshot below match this list.
Header (top): the back arrow and the confirm button for the current step, plus Save and the reject button. Demo cases hide Save and the reject button.
3D view (center): anatomy, implants, guides and PSI designs.
CT slice views: Axial, Coronal and Sagittal views of the scan, shown next to the 3D view when the case has CT data. In the editor you can collapse or expand them.
Side panel (right): tools, measurements and the elements of the current step. Drag its edge to make it wider or narrower.
Anatomy switcher (left): in cases with more than one anatomy, such as reverse shoulder (RSA), click an anatomy to work on it, or open the Combined view to see them together.
The 3D view
Mouse controls
Action | How |
Rotate | Left-click and drag |
Pan | Right-click and drag |
Zoom | Mouse wheel, or middle-click and drag |
Select an element | Click it |
Clear the selection | Press Esc |
On a touch screen, drag with one finger to rotate and pinch with two fingers to zoom. For every mouse control and keyboard shortcut, see Viewer & Navigation Shortcuts.
Selecting and moving elements
When you click an anatomy, implant or guide, it is highlighted and the side panel shows its options. Elements you can move also show movement controls: a gizmo in a free view, step arrows in a fixed Sagittal, Coronal or Axial view, and the arrow keys to nudge 0.5 mm. Not every element can be moved in every step, and movement may be limited to certain directions. This is intentional. See Moving Implants & Planning Elements.
View buttons
Use the Sagittal, Coronal and Axial buttons on the 3D view to jump to a standard view. Click the active button again to look from the opposite side.
Section slider
The vertical slider on the right edge of the 3D view slices through the model so you can inspect internal geometry, depth and fit.
For reverse shoulder (RSA) cases, on the scapula view after the landmark step, a dot appears on the slider. Use it to snap the section to a planning element (for example, a K-wire) so the section follows that element's position and angle. This is useful for checking alignment and depth.
Internal and Surrounding slider
When the CT is loaded, a horizontal slider marked Internal and Surrounding blends the 3D models with the surrounding CT image.
The CT slice views
Scroll the mouse wheel to move through the slices one at a time.
Left-click and drag uses the tool selected above the views: Pan (the default), Zoom, or Window/Level (brightness and contrast).
Right-click and drag always adjusts Window/Level.
Double-click a view to maximize it. Double-click again to return to the grid.
Click a point to center the other views on it.
Use the mode switch to choose Resliced, Internal or Average. In Average mode the Axial view is hidden and slice scrolling is off.
Note: In the editor, the slice views open once the CT has finished loading. Until then, a progress bar shows how far it has loaded.
The side panel
The side panel changes with the step, the selected element and what the procedure supports. Depending on the step, it can include:
The Pre-Op / Post-Op switch, to compare the anatomy before and after planning. In the landmark step it is shown but locked. It is not available for cranioplasty (CRP).
Undo and Comments, at the top right of the side panel. Demo cases have no Comments button.
Measurements, under Pre-Op Measurements or Post-Op Measurements.
Element groups, for example an implant with its body, screws and other parts.
Show and hide elements
Click the eye icon next to a group or part to show or hide it. Hiding a parent group hides everything in it. Use this to reduce clutter and focus on one structure.
Swap templates
Where supported, choose a different template or component from the element's group in the side panel. See Implant Templates & PSI Design.
Measurements
Click a measurement in the side panel to highlight it in the 3D view and, when available, show its description. The 3D visualization is always the source of truth. Some measurements can be edited in Post-Op, and you can add your own. See Measurements: Understanding, Editing & Limitations.
Saving and confirming
Save (the disk icon in the header) keeps your work in the current step without moving on, so you can continue later.
The confirm button saves the step and takes you to the next one. Its label depends on the step: Confirm Landmarks, Confirm Reduction, Confirm Surgery Plan or Generate PSI, and Confirm PSI or Update PSI. On small screens it reads Confirm.
Measurements you add yourself are saved as you go, with no need to click Save.
Important: All other changes need Save or confirm. If you leave the page, refresh or switch steps before that, those changes are lost.
If the confirm button is disabled, hover over it to see why. Common reasons are missing required landmarks, data that is still loading, or the Combined view being open (switch to a single anatomy view to continue).
Rejecting a step
If you are not satisfied with the result of a step, click the red X in the header. Write a note of at least 50 characters that explains the problem, then click the reject button. The step is sent for review, and you receive an email when the review is complete. Until then, the step is view-only for you.
Who can confirm and approve
Saving, confirming or rejecting a step requires edit access to the case. Final approval with Approve Case requires Approver access. Technicians and Organization Supervisors do not have edit access, so they can review the plan but not change it. See User Roles & Permissions.
Approve Case
After the last planning step, the Approve Case button appears on the approval page. While another anatomy in the case is not planned yet, the same button reads Sign off. You then confirm a Responsibility Acknowledgment with Approve & Acknowledge, and the Plan Report is updated with the approved plan. Approval finalizes the case outputs. See Approving a Case.
Undo
Click Undo in the side panel, or press Ctrl+Z (Cmd+Z on Mac), to reverse your last change. Template or implant swaps and PSI type changes cannot be undone, and there is no redo. See Saving, Confirmations, Undo & Reset.
Starting point and clinical responsibility
When you open a planning step, the implants and positions you see are a starting point for your plan. They are not clinical recommendations. You can swap templates and move implants as needed. Final clinical decisions are always made by the user.
Going back and versions
Use the back arrow in the header to return to a previous step. Changing an earlier step can reset the later steps that depend on it, and after PSI confirmation, new confirmations create new versions. See Case Workflow Navigation & Versioning.
Best practices
Save or confirm often.
Validate landmarks early.
Use show and hide to reduce clutter.
Click measurements to understand how they are calculated.
Use the section slider to check depth.
Go back and iterate when you need to.
When to stop and review
Pause and review if:
Measurements don't match your expectations.
The anatomy orientation looks wrong.
Elements behave unexpectedly.
You are not sure whether a change was saved.
If needed, refresh the page to return the current step to its last saved state.
Need help?
If something in the Editor or Viewer doesn't behave as expected, see Performance, Viewer & Technical Issues or contact CustoMED support.