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Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series

(1) Introduction: The laparoscopic approach to low pelvic tumors is challenging and hindered by suboptimal tumor visualization and dissection, with possible oncological failure. Stereotactic navigation provides real-time image guidance that may optimize safety, accuracy, and precision when dissectin...

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Main Authors: Piozzi, Guglielmo Niccolo, Kwak, Jung-Myun, Kim, Ji-Seon, Baek, Se-Jin, Kim, Jin, Kim, Seon-Hahn
Format: Article
Published: MDPI 2024
Subjects:
R Medicine (General)
RD Surgery
Online Access:http://eprints.um.edu.my/45527/
https://doi.org/10.3390/jcm13051233
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spelling my.um.eprints.455272024-10-28T01:38:57Z http://eprints.um.edu.my/45527/ Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series Piozzi, Guglielmo Niccolo Kwak, Jung-Myun Kim, Ji-Seon Baek, Se-Jin Kim, Jin Kim, Seon-Hahn R Medicine (General) RD Surgery (1) Introduction: The laparoscopic approach to low pelvic tumors is challenging and hindered by suboptimal tumor visualization and dissection, with possible oncological failure. Stereotactic navigation provides real-time image guidance that may optimize safety, accuracy, and precision when dissecting challenging low pelvic tumors. (2) Methods: Preoperative CT images were acquired with eight skin-fixed fiducials and loaded into a navigation system. A patient tracker was mounted on the bed side. Patient-to-image paired point registration was performed, and an instrument tracker was mounted on a laparoscopic instrument and calibrated for instrument tracking. Surgical operations were performed with real-time stereotactic navigation assistance. (3) Results: Three patients underwent stereotactic navigation surgery. Fiducial registration errors were good to optimal (+/- 1.9, +/- 3.4, and +/- 3.4 mm). Lesions were easily identified and targeted with real-time navigation. Surgeries were uneventful. Histopathology examinations identified one retro-rectal schwannoma, one lateral pelvic recurrence from rectal adenocarcinoma, and one advanced anal canal carcinoma. No navigation-related complications, readmissions, or postoperative mortalities were observed. (4) Conclusions: The application of laparoscopic stereotactic navigation surgery to complex low pelvic tumors is feasible and could impact oncological surgical quality by enabling tumor targeting and ensuring resection margins. Further wider series are needed to confirm stereotactic navigation's impact on challenging low pelvic tumors. MDPI 2024-03 Article PeerReviewed Piozzi, Guglielmo Niccolo and Kwak, Jung-Myun and Kim, Ji-Seon and Baek, Se-Jin and Kim, Jin and Kim, Seon-Hahn (2024) Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series. Journal of Clinical Medicine, 13 (5). p. 1233. ISSN 2077-0383, DOI https://doi.org/10.3390/jcm13051233 <https://doi.org/10.3390/jcm13051233>. https://doi.org/10.3390/jcm13051233 10.3390/jcm13051233
institution Universiti Malaya
building UM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaya
content_source UM Research Repository
url_provider http://eprints.um.edu.my/
topic R Medicine (General)
RD Surgery
spellingShingle R Medicine (General)
RD Surgery
Piozzi, Guglielmo Niccolo
Kwak, Jung-Myun
Kim, Ji-Seon
Baek, Se-Jin
Kim, Jin
Kim, Seon-Hahn
Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series
description (1) Introduction: The laparoscopic approach to low pelvic tumors is challenging and hindered by suboptimal tumor visualization and dissection, with possible oncological failure. Stereotactic navigation provides real-time image guidance that may optimize safety, accuracy, and precision when dissecting challenging low pelvic tumors. (2) Methods: Preoperative CT images were acquired with eight skin-fixed fiducials and loaded into a navigation system. A patient tracker was mounted on the bed side. Patient-to-image paired point registration was performed, and an instrument tracker was mounted on a laparoscopic instrument and calibrated for instrument tracking. Surgical operations were performed with real-time stereotactic navigation assistance. (3) Results: Three patients underwent stereotactic navigation surgery. Fiducial registration errors were good to optimal (+/- 1.9, +/- 3.4, and +/- 3.4 mm). Lesions were easily identified and targeted with real-time navigation. Surgeries were uneventful. Histopathology examinations identified one retro-rectal schwannoma, one lateral pelvic recurrence from rectal adenocarcinoma, and one advanced anal canal carcinoma. No navigation-related complications, readmissions, or postoperative mortalities were observed. (4) Conclusions: The application of laparoscopic stereotactic navigation surgery to complex low pelvic tumors is feasible and could impact oncological surgical quality by enabling tumor targeting and ensuring resection margins. Further wider series are needed to confirm stereotactic navigation's impact on challenging low pelvic tumors.
format Article
author Piozzi, Guglielmo Niccolo
Kwak, Jung-Myun
Kim, Ji-Seon
Baek, Se-Jin
Kim, Jin
Kim, Seon-Hahn
author_facet Piozzi, Guglielmo Niccolo
Kwak, Jung-Myun
Kim, Ji-Seon
Baek, Se-Jin
Kim, Jin
Kim, Seon-Hahn
author_sort Piozzi, Guglielmo Niccolo
title Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series
title_short Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series
title_full Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series
title_fullStr Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series
title_full_unstemmed Stereotactic Navigation-Assisted Laparoscopic Resection of Challenging Low Pelvic Tumors: A Case Series
title_sort stereotactic navigation-assisted laparoscopic resection of challenging low pelvic tumors: a case series
publisher MDPI
publishDate 2024
url http://eprints.um.edu.my/45527/
https://doi.org/10.3390/jcm13051233
_version_ 1814933234317787136
score 13.211869

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