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

2025-05-23

Journal of Orthopaedic Research

AI Summary

Pelvic bone tumor resection is challenging due to complex anatomy and limited intraoperative visibility, often resulting in inaccurate tumor localization. Existing navigation systems suffer from high cost, ionizing radiation exposure, cumbersome intraoperative registration, lengthy preoperative preparation, and lack of reusability. To address these limitations, this study proposes a vision-based surgical navigation system integrating real-time optical tracking with modular, adjustable cutting guides. The system introduces a novel registration-free, display-free real-time visual guidance paradigm and achieves both patient-specific adaptation and reusability through its modular guide design. Experimental evaluation demonstrates that, compared to freehand surgery, the system reduces mean spatial targeting error by 51% (from 2.07 mm to 1.01 mm), with all errors remaining below 3 mm. Roll and pitch angular deviations decrease by 72% and 70%, respectively (p < 0.03), significantly enhancing surgical accuracy and clinical practicality.

Technology Category

• Computer Vision: Multi-modal Vision
• Intelligent Robots: Localization, Mapping, and Navigation
• Planning, Routing, and Scheduling: Optimization of Spatio-temporal Systems

Application Category

• User Modeling, Personalization and Recommendation: On-Device user modeling, personalization, and recommendation
• Systems and Infrastructure for Web, Mobile and WoT: Experiences and lessons learnt from Web-based algorithms and system deployments
• Security and Privacy: Large-scale security measurements

Abstract

Pelvic bone tumor resections remain significantly challenging due to complex three-dimensional anatomy and limited surgical visualization. While accurate, current navigation systems and patient-specific instruments 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 male pelvis sawbones were used, with each hemipelvis randomly assigned to either the vision-guided and modular jig system or the traditional freehand method. A total of 20 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 ± 1.71 mm to 1.01 ± 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 ± 17.57° to 4.21 ± 3.46° (p = 0.0275), and pitch angle deviation decreased from 6.17 ± 4.58° to 1.84 ± 1.48° (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.

Problem

• Enhancing accuracy in pelvic tumor resections with real-time vision guidance.
• Addressing limitations of current navigation systems like high cost and workflow disruption.
• Validating a modular jig system to reduce resection errors significantly.

Innovation

• Real-time vision-guided surgical system
• Modular jigs for precise resections
• Optical tracking for improved accuracy