Computer-Assisted Pelvic Tumor Resection: Fields of Application, Limits, and Perspectives

Fehlberg, S.; Eulenstein, Sebastian; Lange, Thomas; Andreou, Dimosthenis; Tunn, Per‐Ulf

doi:10.1007/978-3-540-77960-5_11

Cited by 22 publications

(17 citation statements)

References 54 publications

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“…Since the 2000s, computer-assisted technologies have been developed for pelvic bone tumor surgeries with the main objective of improving bone-cutting accuracy [13][14][15]. Several planning and navigation systems are available, and surgeons are now benefiting from a real-time navigated process for the positioning of surgical cutting tools such as osteotomes [16], chisels [17], drills [18,19], burrs [20,21] and oscillating saws [22][23][24].…”

Section: Introductionmentioning

confidence: 99%

“…To date, however, few clinical studies have reported quantitative data on achieved margins during navigation-assisted bone tumor resections [15,25,26]. Examples of data reported include maximum differences ranging from 4 to 10 mm between the preoperatively planned margins and those visualized on postoperative CT or excised histological actual margins.…”

Section: Introductionmentioning

confidence: 99%

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Computer-assisted planning and navigation improves cutting accuracy during simulated bone tumor surgery of the pelvis

Cartiaux

Banse

Laurent

et al. 2012

Computer Aided Surgery

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Background: Resection of bone tumors within the pelvis requires good cutting accuracy to achieve satisfactory safe margins. Manually controlled bone cutting can result in serious errors, especially due to the complex three-dimensional geometry, limited visibility, and restricted working space of the pelvic bone. This experimental study investigated cutting accuracy during navigated and non-navigated simulated bone tumor cutting in the pelvis. Methods: A periacetabular tumor resection was simulated using a pelvic bone model. Twenty-three operators (10 senior and 13 junior surgeons) were asked to perform the tumor cutting, initially according to a freehand procedure and later with the aid of a navigation system. Before cutting, each operator used preoperative planning software to define four target planes around the tumor with a 10-mm desired safe margin. After cutting, the location and flatness of the cut planes were measured, as well as the achieved surgical margins and the time required for each cutting procedure. Results: The location of the cut planes with respect to the target planes was significantly improved by using the navigated cutting procedure, averaging 2.8 mm as compared to 11.2 mm for the freehand cutting procedure ( p < 0.001). There was no intralesional tumor cutting when using the navigation system. The maximum difference between the achieved margins and the 10-mm desired safe margin was 6.5 mm with the navigated cutting process (compared to 13 mm with the freehand cutting process). Conclusions: Cutting accuracy during simulated bone cuts of the pelvis can be significantly improved by using a freehand process assisted by a navigation system. When fully validated with complementary in vivo studies, the planning and navigation-guided technologies that have been developed for the present study may improve bone cutting accuracy during pelvic tumor resection by providing clinically acceptable margins.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Computer-assisted planning and navigation improves cutting accuracy during simulated bone tumor surgery of the pelvis

Cartiaux

Banse

Laurent

et al. 2012

Computer Aided Surgery

View full text Add to dashboard Cite

show abstract

“…The current platforms register patient to image data through rigid body transformations [11]. This technique is dependent on the fact that bone is a rigid and nondeformable structure and that the relationship between points is maintained on imaging and on the patient.…”

Section: Methods Of Navigationmentioning

confidence: 99%

Potential use of computer navigation in the treatment of primary benign and malignant tumors in children

Saidi

2012

Curr Rev Musculoskelet Med

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“…Fehlberg et al in their series noted a median deviation of 3.3 mm between the planned and performed osteotomy levels when comparing CT and three dimensional reconstructions. 20 They postulate that this could be due to a number or combination of factors including; minor registration inaccuracy combined with surgical inaccuracy; spatial factors which render the planned osteotomy impossible to realise; minor expansion and movability of the pelvis once the pelvic ring is open preventing exact pre and post-operative comparison.…”

Section: Limitations Of Cas Timementioning

confidence: 99%

(iii) Computer assisted navigation in musculoskeletal oncology

Young

Findlay

Patton

et al. 2014

Orthopaedics and Trauma

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Computer-Assisted Pelvic Tumor Resection: Fields of Application, Limits, and Perspectives

Cited by 22 publications

References 54 publications

Computer-assisted planning and navigation improves cutting accuracy during simulated bone tumor surgery of the pelvis

Computer-assisted planning and navigation improves cutting accuracy during simulated bone tumor surgery of the pelvis

Potential use of computer navigation in the treatment of primary benign and malignant tumors in children

(iii) Computer assisted navigation in musculoskeletal oncology

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