TY - JOUR
T1 - Prospective study on image-guided navigation surgery for pelvic malignancies
AU - Nijkamp, Jasper
AU - Kuhlmann, Koert F.D.
AU - Ivashchenko, Oleksandra
AU - Pouw, Bas
AU - Hoetjes, Nikie
AU - Lindenberg, Melanie A.
AU - Aalbers, Arend G.J.
AU - Beets, Geerard L.
AU - van Coevorden, Frits
AU - KoK, Niels
AU - Ruers, Theo J.M.
PY - 2019/3/15
Y1 - 2019/3/15
N2 - Background and objectives: Surgery of advanced tumors and lymph nodes in the pelvis can be challenging due to the narrow pelvic space and vital surrounding structures. This study explores the application of a novel electromagnetic navigation system to guide pelvic surgery.Methods: This was a prospective study on surgery for malignancies in the pelvis. Preoperatively obtained imaging was used to create a patient-specific three-dimensional (3D) roadmap. In the operating room, the 3D roadmap was registered to an intraoperative computed tomography scan. A tracked pointer was used during surgery for guidance. Primary endpoint was safety and feasibility, secondary endpoints were accuracy and usability.Results: Twenty-eight colorectal, four liposarcomas, and one gynecological patient were included. There were no safety issues. Navigation was feasible in 31 patients. The mean target registration errors of 4.0 and 6.3 mm were achieved for straight and French position, respectively. In seven of seven patients with a locally advanced rectal tumor and in seven of eight patients with recurrences, negative margins were achieved. Thirty-three of 36 target lymph nodes were successfully removed. Surgeons using the system indicated faster localization of the tumor and improved decisiveness.Conclusion: This novel surgical navigation system was safe and feasible during pelvic surgery and can facilitate its users.
AB - Background and objectives: Surgery of advanced tumors and lymph nodes in the pelvis can be challenging due to the narrow pelvic space and vital surrounding structures. This study explores the application of a novel electromagnetic navigation system to guide pelvic surgery.Methods: This was a prospective study on surgery for malignancies in the pelvis. Preoperatively obtained imaging was used to create a patient-specific three-dimensional (3D) roadmap. In the operating room, the 3D roadmap was registered to an intraoperative computed tomography scan. A tracked pointer was used during surgery for guidance. Primary endpoint was safety and feasibility, secondary endpoints were accuracy and usability.Results: Twenty-eight colorectal, four liposarcomas, and one gynecological patient were included. There were no safety issues. Navigation was feasible in 31 patients. The mean target registration errors of 4.0 and 6.3 mm were achieved for straight and French position, respectively. In seven of seven patients with a locally advanced rectal tumor and in seven of eight patients with recurrences, negative margins were achieved. Thirty-three of 36 target lymph nodes were successfully removed. Surgeons using the system indicated faster localization of the tumor and improved decisiveness.Conclusion: This novel surgical navigation system was safe and feasible during pelvic surgery and can facilitate its users.
KW - Electromagnetic tracking
KW - Locally advanced rectal cancer
KW - Pelvic recurrences
KW - Surgical navigation
KW - 2023 OA procedure
UR - http://www.scopus.com/inward/record.url?scp=85059025864&partnerID=8YFLogxK
U2 - 10.1002/jso.25351
DO - 10.1002/jso.25351
M3 - Article
C2 - 30582622
AN - SCOPUS:85059025864
SN - 0022-4790
VL - 119
SP - 510
EP - 517
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
IS - 4
ER -
