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使用实时视觉引导手术系统提高盆腔肿瘤切除术的准确性。

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

作者信息

Danesh Vahid, Arauz Paul, Boroji Maede, Zhu Andrew, Cottone Mia, Gould Elaine, Khan Fazel A, Kao Imin

机构信息

Department of Mechanical Engineering, Stony Brook University, Stony Brook, New York, USA.

Department of Orthopedics, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.

出版信息

J Orthop Res. 2025 Aug;43(8):1485-1492. doi: 10.1002/jor.26111. Epub 2025 May 23.

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.

摘要

由于骨盆复杂的三维解剖结构以及手术可视化受限,骨盆骨肿瘤切除术仍然具有极大的挑战性。尽管当前的导航系统和定制器械准确,但也存在局限性,包括成本高、辐射暴露、工作流程中断、生产时间长以及缺乏可重复使用性。本研究评估了一种结合模块化夹具的实时视觉引导手术系统,以提高骨盆骨肿瘤切除术的准确性。开发并验证了一种结合模块化切割夹具和实时光学跟踪的视觉引导手术系统。使用了五个男性骨盆模型,每个半骨盆随机分配到视觉引导和模块化夹具系统或传统徒手方法。每种方法共分析了20个切除平面。通过测量与计划切除平面的距离和角度偏差来评估准确性。与徒手方法相比,视觉引导和模块化夹具系统显著提高了切除准确性,平均距离偏差从2.07±1.71毫米降至1.01±0.78毫米(p = 0.0193)。特别是,所有使用视觉引导系统切除的标本误差均小于3毫米。角度偏差也有显著改善,滚动角偏差从15.36±17.57°降至4.21±3.46°(p = 0.0275),俯仰角偏差从6.17±4.58°降至1.84±1.48°(p < )。所提出的视觉引导和模块化夹具系统在保持工作流程效率的同时,显著提高了骨盆骨肿瘤切除术的准确性。这种经济高效的解决方案提供实时引导,无需参考外部监视器,有可能改善复杂骨盆骨肿瘤病例的手术结果。

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