scholarly journals Computer-Assisted Resection and Reconstruction of Pelvic Tumor Sarcoma

Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Pierre-Louis Docquier ◽  
Laurent Paul ◽  
Olivier Cartiaux ◽  
Christian Delloye ◽  
Xavier Banse
Keyword(s):  
Surgical Navigation ◽  
Tumor Resection ◽  
Surgical Margin ◽  
Surgical Oncology ◽  
Tumor Location ◽  
Resection Margins ◽  
Computer Assisted ◽  
Navigation Systems ◽  
First Case ◽  
Saw Blade

Pelvic sarcoma is associated with a relatively poor prognosis, due to the difficulty in obtaining an adequate surgical margin given the complex pelvic anatomy. Magnetic resonance imaging and computerized tomography allow valuable surgical resection planning, but intraoperative localization remains hazardous. Surgical navigation systems could be of great benefit in surgical oncology, especially in difficult tumor location; however, no commercial surgical oncology software is currently available. A customized navigation software was developed and used to perform a synovial sarcoma resection and allograft reconstruction. The software permitted preoperative planning with defined target planes and intraoperative navigation with a free-hand saw blade. The allograft was cut according to the same planes. Histological examination revealed tumor-free resection margins. Allograft fitting to the pelvis of the patient was excellent and allowed stable osteosynthesis. We believe this to be the first case of combined computer-assisted tumor resection and reconstruction with an allograft.

scholarly journals Augmented Reality as a Tool to Guide PSI Placement in Pelvic Tumor Resections

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 7824
Author(s):  
Mónica García-Sevilla ◽  
Rafael Moreta-Martinez ◽  
David García-Mato ◽  
Alicia Pose-Diez-de-la-Lastra ◽  
Rubén Pérez-Mañanes ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Surgical Navigation ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Target Surface ◽  
Patient Specific ◽  
Resection Margins ◽  
Navigation Systems ◽  
Pelvic Tumor ◽  
Similar Accuracy

Patient-specific instruments (PSIs) have become a valuable tool for osteotomy guidance in complex surgical scenarios such as pelvic tumor resection. They provide similar accuracy to surgical navigation systems but are generally more convenient and faster. However, their correct placement can become challenging in some anatomical regions, and it cannot be verified objectively during the intervention. Incorrect installations can result in high deviations from the planned osteotomy, increasing the risk of positive resection margins. In this work, we propose to use augmented reality (AR) to guide and verify PSIs placement. We designed an experiment to assess the accuracy provided by the system using a smartphone and the HoloLens 2 and compared the results with the conventional freehand method. The results showed significant differences, where AR guidance prevented high osteotomy deviations, reducing maximal deviation of 54.03 mm for freehand placements to less than 5 mm with AR guidance. The experiment was performed in two versions of a plastic three-dimensional (3D) printed phantom, one including a silicone layer to simulate tissue, providing more realism. We also studied how differences in shape and location of PSIs affect their accuracy, concluding that those with smaller sizes and a homogeneous target surface are more prone to errors. Our study presents promising results that prove AR’s potential to overcome the present limitations of PSIs conveniently and effectively.

Image-Guided Spinal Surgery and Robotics in MIS: Where Are We Now?

2018 ◽  
Vol 1 (2) ◽  
pp. 2
Author(s):  
Chiung Chyi Shen
Keyword(s):  
Pedicle Screw ◽  
Spinal Surgery ◽  
Surgical Navigation ◽  
Improve Patient Safety ◽  
Intraoperative Imaging ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Image Guided

Use of pedicle screws is widespread in spinal surgery for degenerative, traumatic, and oncological diseases. The conventional technique is based on the recognition of anatomic landmarks, preparation and palpation of cortices of the pedicle under control of an intraoperative C-arm (iC-arm) fluoroscopy. With these conventional methods, the median pedicle screw accuracy ranges from 86.7% to 93.8%, even if perforation rates range from 21.1% to 39.8%.The development of novel intraoperative navigational techniques, commonly referred to as image-guided surgery (IGS), provide simultaneous and multiplanar views of spinal anatomy. IGS technology can increase the accuracy of spinal instrumentation procedures and improve patient safety. These systems, such as fluoroscopy-based image guidance ("virtual fluoroscopy") and computed tomography (CT)-based computer-guidance systems, have sensibly minimized risk of pedicle screw misplacement, with overall perforation rates ranging from between 14.3% and 9.3%, respectively."Virtual fluoroscopy" allows simultaneous two-dimensional (2D) guidance in multiple planes, but does not provide any axial images; quality of images is directly dependent on the resolution of the acquired fluoroscopic projections. Furthermore, computer-assisted surgical navigation systems decrease the reliance on intraoperative imaging, thus reducing the use of intraprocedure ionizing radiation. The major limitation of this technique is related to the variation of the position of the patient from the preoperative CT scan, usually obtained before surgery in a supine position, and the operative position (prone). The next technological evolution is the use of an intraoperative CT (iCT) scan, which would allow us to solve the position-dependent changes, granting a higher accuracy in the navigation system. 

scholarly journals Periacetabular Osteotomy Performed with Imageless Computer-Assisted Navigation: Case Report

2019 ◽  
Vol 2 (1-3) ◽  
pp. 33-39
Author(s):  
Atul F. Kamath ◽  
Rachel R. Mays
Keyword(s):  
Surgical Navigation ◽  
Periacetabular Osteotomy ◽  
Computer Navigation ◽  
Developmental Dysplasia ◽  
Computer Assisted ◽  
Developmental Hip Dysplasia ◽  
Assisted Navigation ◽  
First Case ◽  
Acetabular Fragment ◽  
Pao Surgery

Periacetabular osteotomy (PAO) is an effective surgical treatment for developmental hip dysplasia. The goal of PAO is to reorient the acetabulum to increase acetabular coverage of the femoral head, as well as to reduce contact pressures within the hip joint. The primary challenge of PAO is to accurately achieve the desired acetabular fragment orientation, while maximizing containment and congruency. As key parts of the procedure are performed out of direct field of view of the surgeon, combined with this challenge of precise spatial orientation, there is a potential role for technologies such as surgical navigation. Adjunctive technology may provide information on the orientation of repositioned acetabulum and may offer a useful assist in performing PAO. Here, we present a case of developmental dysplasia of the hip treated via PAO with the addition of an imageless computer navigation device. Surgery was successful, and, at 3 months after procedure, the patient was progressing well. To our best knowledge, this is the first case using imageless computer-assisted navigation in PAO surgery.

Computer Assisted Navigation Systems for Hip and Knee Reconstructive Surgery: Evaluation of Traditional Surgical Technique

2001 ◽  
Author(s):  
Anthony M. DiGioia ◽  
Frederic Picard ◽  
Branislav Jaramaz ◽  
David Sell ◽  
James C. Moody ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Patient Outcomes ◽  
Reconstructive Surgery ◽  
Surgical Navigation ◽  
Surgical Techniques ◽  
Measurement Tool ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Assisted Navigation ◽  
Surgical Navigation System

Abstract In this paper we describe a surgical navigation system named HipNav (Hip-Navigation) for THR and KneeNav (Knee-Navigation) for TKR with an emphasis on using these systems as a real time intraoperative measurement tool (these enabling technologies are the surgical toolbox of the future). This approach will permit the direct comparison of patient outcomes with measurable surgical techniques.

Frameless stereotaxy with scalp-applied fiducial markers for brain biopsy procedures: experience in 218 cases

1999 ◽  
Vol 91 (4) ◽  
pp. 569-576 ◽  
Author(s):  
Gene H. Barnett ◽  
David W. Miller ◽  
Joseph Weisenberger
Keyword(s):  
Surgical Navigation ◽  
Brain Biopsy ◽  
Computer Assisted ◽  
Frameless Stereotaxy ◽  
Complication Rates ◽  
Navigation Systems ◽  
Fiducial Markers ◽  
Content Type ◽  
Wound Breakdown ◽  
Fine Print

Object. The goal of this study was to develop and assess the use and limitations of performing brain biopsy procedures by using image-guided surgical navigation systems (SNSs; that is, frameless stereotactic systems) with scalp-applied fiducial markers.Methods. Two hundred eighteen percutaneous brain biopsies were performed in 213 patients by using a frameless stereotactic SNS that operated with either sonic or optical digitizer technology and scalp-applied fiducial markers for the purpose of registering image space with operating room space. Common neurosurgical and stereotactic instrumentation was adapted for use with a localizing wand, and recently developed target and trajectory guidance software was used.Eight (3.7%) of the 218 biopsy specimens were nondiagnostic; five of these (2.4%) were obtained during procedures in 208 supratentorial lesions and three were obtained during procedures in 10 infratentorial lesions (30%; p < 0.001). Complications related to the biopsy procedure occurred in eight patients (seven of whom had supratentorial lesions and one of whom had an infratentorial lesion, p > 0.25). Five complications were intracerebral hemorrhages (two of which required craniotomy), two were infections, and one was wound breakdown after instillation of intratumoral carmustine following biopsy. There were only three cases of sustained morbidity, and there were two deaths and one delayed deterioration due to disease progression.Two surgeons performed the majority of the procedures (193 cases). The three surgeons who performed more than 10 biopsies had complication rates lower than 5%, whereas two of the remaining four surgeons had complication rates greater than 10% (p = 0.15).Twenty-three additional procedures were performed in conjunction with the biopsies: nine brachytherapies; five computer-assisted endoscopies; four cyst aspirations; two instillations of carmustine; two placements of Ommaya reservoirs; and one craniotomy.Conclusions. Brain biopsy procedures in which guidance is provided by a frameless stereotactic SNS with scalp-applied fiducial markers represents a safe and effective alternative to frame-based stereotactic procedures for supratentorial lesions. There were comparable low rates of morbidity and a high degree of diagnostic success. Strategies for performing posterior fossa biopsies are suggested.

Biomedical Information Processing and Visualization for Minimally Invasive Neurosurgery

2012 ◽  
pp. 36-46
Author(s):  
Hongen Liao
Keyword(s):  
Information Processing ◽  
Minimally Invasive ◽  
Medical Information ◽  
Surgical Navigation ◽  
Tumor Resection ◽  
Three Dimensional ◽  
Navigation Systems ◽  
Minimally Invasive Neurosurgery ◽  
Invasive Treatment ◽  
Magnetic Resonance Imaging Mri

This chapter demonstrates a particular application of biomedical information processing and visualization techniques for minimally invasive diagnosis and therapy in neurosurgery. Computer-assisted surgical navigation provides surgeons valuable information on the precision location of surgical targets and critical areas, as well as the positions of surgical instruments. However, most navigation systems use pre-/intra-operative images, which are displayed on a two-dimensional (2D) display situated away from the surgical field. These setups force the surgeon to take extra steps to match navigation information on the display with the actual surgical target of the patient. Two typical medical information-based navigation systems for neurosurgery are described in this chapter. First, an integration system with fluorescence-based intra-operative diagnosis and laser ablation-based, high-precision, minimally invasive treatment is introduced. Second, an autostereoscopic image-guided surgical system developed for minimally invasive neurosurgery is discussed. The autostereoscopic image and corresponding augmented reality with three-dimensional (3D) image overlay have been used in open magnetic resonance imaging (MRI)-guided neurosurgery. These techniques enable intra-operative visualization of surgical targets for precision tumor resection.

A novel 4 camera multi-stereo tracking system for application in surgical navigation systems

2020 ◽  
Vol 87 (7-8) ◽  
pp. 451-458
Author(s):  
Oliver Gieseler ◽  
Hubert Roth ◽  
Jürgen Wahrburg
Keyword(s):  
Operating Room ◽  
Surgical Navigation ◽  
Tracking System ◽  
Computer Assisted Surgery ◽  
Optical Tracking ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Camera Model ◽  
Camera System ◽  
Industrial Cameras

AbstractIn this paper, we present a novel 4 camera stereo system for application as optical tracking component in navigation systems in computer-assisted surgery. This shall replace a common stereo camera system in several applications. The objective is to provide a tracking component consisting of four single industrial cameras. The system can be built up flexibly in the operating room e. g. at the operating room lamp. The concept is characterized by independent, arbitrary camera mounting poses and demands easy on-site calibration procedures of the camera setup. Following a short introduction describing the environment, motivation and advantages of the new camera system, a simulation of the camera setup and arrangement is depicted in Section 2. From this, we gather important information and parameters for the hardware setup, which is described in Section 3. Section 4 includes the calibration of the cameras. Here, we illustrate the background of camera model and applied calibration procedures, a comparison of calibration results obtained with different calibration programs and a new concept for fast and easy extrinsic calibration.

Simultaneous Image-Guided Skull Bone Tumor Resection and Reconstruction With a Preconstructed Prosthesis Based on an OsiriX Virtual Resection

2015 ◽  
Vol 11 (4) ◽  
pp. 484-490 ◽  
Author(s):  
Michaël Bruneau ◽  
Rachid Kamouni ◽  
Frédéric Schoovaerts ◽  
Henri-Benjamin Pouleau ◽  
Olivier De Witte
Keyword(s):  
Surgical Navigation ◽  
Tumor Resection ◽  
Preoperative Imaging ◽  
Computer Assisted ◽  
Virtual Planning ◽  
Prosthetic Reconstruction ◽  
Skull Tumor ◽  
Skull Reconstruction ◽  
Custom Made ◽  
Bone Tumor Resection

Abstract BACKGROUND Skull reconstruction can be challenging due to the complex 3-dimensional shape of some structures, such as the orbital walls, and for cases involving a large cranial vault. In such situations, computer-assisted design and modeling of prostheses is especially helpful to achieve an adequate reconstruction. Simultaneous tumor resection and skull defect reconstruction are also challenging because the preoperative imaging does not display the anticipated defect. Currently, sophisticated methods based on physical prototypes and templates are required to enable simultaneous resection and reconstruction techniques. OBJECTIVE To report a new technique for simultaneous tumor resection and skull reconstruction with a custom-made prosthesis. METHODS Using OsiriX software, virtual bone resection was performed using preoperative images by carefully delimiting the tumor on each slice. The modified images were integrated to predict the defect and also served as a basis for prosthesis construction. At the time of surgery, the images were projected onto the patient's skull using a surgical navigation system to delimit the area of the craniectomy. RESULTS The virtual planning method was simple and accurate and provided a precise preoperative definition of important structures that needed to be spared, such as the frontal sinus. Using this method, simultaneous tumor resection and prosthetic skull reconstruction was successfully achieved for a patient with a wide skull tumor. CONCLUSION Simultaneous skull tumor resection and prosthetic reconstruction are possible when a virtual preoperative tumor resection is performed, and a corresponding customized prosthesis subsequently is manufactured and used.

scholarly journals Management of Early Glottic Cancer Treated by CO2 Laser According to Surgical-Margin Status: A Systematic Review of the Literature

2020 ◽  
Author(s):  
Barbara Verro ◽  
Giuseppe Greco ◽  
Enzo Chianetta ◽  
Carmelo Saraniti
Keyword(s):  
Co2 Laser ◽  
Tumor Resection ◽  
Surgical Margin ◽  
Disease Free Survival ◽  
Glottic Cancer ◽  
Resection Margins ◽  
Second Look ◽  
Key Points ◽  
The Status

Introduction Transoral laser microsurgery (TLM) is the treatment of choice for Tis-T2 squamous cell glottic carcinomas due to its advantages compared with open surgery and radiotherapy. However, the CO2 laser beam causes changes and damage on the specimens, making the histological assessment of resection margins, the gold standard for confirming radical tumor resection, sometimes difficult. Objective To assess the different ways to manage patients depending on the status of the histopathological margin according to recent studies to detect the most commonly shared therapeutic strategy. Data Synthesis We analyzed the literature available on the PubMed and Web of Science databases, including only articles published since 2005, using specific keywords to retrieve articles whose titles and abstracts were read and analyzed independently by two authors to detect relevant studies. Therefore, we focused on disease-free survival, overall survival, local control, laryngeal preservation, and disease-specific survival. Thus, 17 studies were included in the present review; they were grouped according to the status of the histological margin, and we analyzed the different management policies described in them. This analysis showed that there is not a shared strategy, though in most studies the authors performed a second-look surgery in the cases of positive margins and a close follow-up in cases of negative ones. The main disagreement is regarding the management of close or non-valuable resection margins, since some some authors performed a second-look surgery, and others, a close follow-up. Conclusions Definitely, the most shared policy is the second-look surgery in case of positive surgical margins, and a close follow-up in case of close or non-valuable resection margins. Key Points

Computer-Assisted Surgical Navigation for Primary and Metastatic Bone Malignancy of the Pelvis: Current Evidence and Future Directions

2021 ◽  
pp. 155633162110281
Author(s):  
Alexander B. Christ ◽  
Derek G. Hansen ◽  
John H. Healey ◽  
Nicola Fabbri
Keyword(s):  
Bone Metastases ◽  
Bone Tumor ◽  
Surgical Navigation ◽  
Tumor Resection ◽  
Computer Assisted Surgery ◽  
Current Evidence ◽  
Pelvic Bone ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Bony Pelvis

Computer-assisted navigation and robotic surgery have gained popularity in the treatment of pelvic bone malignancies, given the complexity of the bony pelvis, the proximity of numerous vital structures, and the historical challenges of pelvic bone tumor surgery. Initial interest was on enhancing the accuracy in sarcoma resection by improving the quality of surgical margins and decreasing the incidence of local recurrences. Several studies have shown an association between intraoperative navigation and increased incidence of negative margin bone resection, but long-term outcomes of navigation in pelvic bone tumor resection have yet to be established. Historically, mechanical stabilization of pelvic bone metastases has been limited to Harrington-type total hip arthroplasty for disabling periacetabular disease, but more recently, computer-assisted surgery has been employed for minimally invasive percutaneous fixation and stabilization; although still in its incipient stages, this procedure is potentially appealing for treating patients with bone metastases to the pelvis. The authors review the literature on navigation for the treatment of primary and metastatic tumors of the pelvic bone and discuss the best practices and limitations of these techniques.

Sign in / Sign up

Export Citation Format

Share Document