Improved Accuracy in Pelvic Tumor Resections Using a Real-Time Vision-Guided Surgical System

TL;DR

This study presents a real-time vision-guided surgical system with modular jigs that significantly improves the accuracy of pelvic tumor resections, reducing deviations and errors compared to traditional freehand methods.

Contribution

The paper introduces a novel, cost-effective, real-time vision-guided system with modular jigs that enhances surgical accuracy in pelvic tumor resections.

Findings

Reduced mean distance deviation from 2.07 mm to 1.01 mm

Significant decrease in angular deviations, especially pitch angle

All specimens resected with the system had errors less than 3 mm

Abstract

Pelvic bone tumor resections remain significantly challenging due to complex three-dimensional anatomy and limited surgical visualization. Current navigation systems and patient-specific instruments, while accurate, present limitations including high costs, radiation exposure, workflow disruption, long production time, and lack of reusability. This study evaluates a real-time vision-guided surgical system combined with modular jigs to improve accuracy in pelvic bone tumor resections. A vision-guided surgical system combined with modular cutting jigs and real-time optical tracking was developed and validated. Five female pelvis sawbones were used, with each hemipelvis randomly assigned to either the vision-guided and modular jig system or traditional freehand method. A total of twenty resection planes were analyzed for each method. Accuracy was assessed by measuring distance and angular deviations from the planned resection planes. The vision-guided and modular jig system significantly improved resection accuracy compared to the freehand method, reducing the mean distance deviation from 2.07 $\pm$ 1.71 mm to 1.01 $\pm$ 0.78 mm (p=0.0193). In particular, all specimens resected using the vision-guided system exhibited errors of less than 3 mm. Angular deviations also showed significant improvements with roll angle deviation reduced from 15.36 $\pm$ 17.57$^\circ$ to 4.21 $\pm$ 3.46$^\circ$ (p=0.0275), and pitch angle deviation decreased from 6.17 $\pm$ 4.58$^\circ$ to 1.84 $\pm$ 1.48$^\circ$ (p<0.001). The proposed vision-guided and modular jig system significantly improves the accuracy of pelvic bone tumor resections while maintaining workflow efficiency. This cost-effective solution provides real-time guidance without the need for referencing external monitors, potentially improving surgical outcomes in complex pelvic bone tumor cases.