A portable surgical navigation device to display resection planes for bone tumor surgery

Abstract

Introduction: Surgical navigation has been used in musculoskeletal tumor surgical procedures to improve the precision of tumor resection. Despite the favorable attributes of navigation-assisted surgery, conventional systems do not display the resection margin in real time, and preoperative manual input is required. In addition, navigation systems are often expensive and complex, and this has limited their widespread use. In this study, we propose an augmented reality surgical navigation system that uses a tablet personal computer with no external tracking system. Material and methods: We realized a real-time safety margin display based on three-dimensional dilation. The resection plane induced by the safety margin is updated in real time according to the direction of sawing. The minimum separation between the saw and the resection plane is also calculated and displayed. The surgeon can resect bone tumors accurately by referring to the resection plane and the minimum separation updated in real time. Results: The effectiveness of the system was demonstrated with experiments on pig pelvises. When the desired resection margin was 10 mm, the measured resection margin was 9.85 ± 1.02 mm. Conclusions: The proposed method exhibits sufficient accuracy and convenience for use in bone tumor resection. It also has favorable practical applicability due to its low cost and portability. © 2017 SMIT - Society for Minimally Invasive Therapy.