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The paper introduces a computer aided surgical system (CASS) based on the 3D medical images, which is designed for the surgeons to examine the tissues, acquire anatomical structures, diagnose illness and plan surgery. The system takes the 3D medical images as input and designs a segmentation pipeline to segment out the volumes of interested tissues. Then triangle meshes of the interested tissues were constructed by the discrete March Cubes algorithms, which is used to provide surface models for real time processing and rendering. To assist the surgeons with biomechanical simulation, several volume mesh generation approaches are provided to construct tetrahedral and hexahedral meshes for FEM. With this integrated models, the system can provide intuitive visualization of the slice images and focused medical models, as well as several effective computer aided diagnosis tools which are proved valuable in clinical practice.