Application of augmented reality technology in the surgical treatment of patients with primary and recurrent pelvic tumors

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Abstract

Surgical treatment of locally spread tumors of pelvic organs remains an urgent and complicated oncological problem. The recurrence rate after radical treatment ranges from 15.1% to 45.2%. The key to a successful and safe surgical intervention is careful planning and intraoperative navigation, including the use of augmented reality technology. The study presents the experience in the clinical testing of augmented reality technology in the surgical treatment of 11 patients. The paper also described the main stages of the algorithm. Radical operations with intraoperative application of augmented reality technology were performed in eight patients with favorable outcomes. One patient underwent palliative intervention, and two patients did not undergo surgery. In the eight patients who underwent surgery, the median operation time was 202.5 (117.5–282.5) min, the median volume of blood loss was 300 (187.5–625) mL, and the median duration of hospital stay was 21 (17.75––27.75) days. Three patients (37.55%) developed complications, namely, necrosis of the perineal edges of the wound, ascending pyelonephritis, and intrahospital pneumonia. No hospital fatality has been registered. In the postoperative morphological examination, a negative peripheral resection boundary (R0 resection) was achieved in all patients. Subsequently, these patients were referred for dynamic monitoring and systemic antitumor therapy. The application of an augmented reality algorithm in the surgical treatment of primary and recurrent pelvic tumors is feasible and reproducible in clinical practice. Augmented reality technology, with its innovative nature and obvious advantages, opens up certain prospects for improving the results of multivisceral resections of pelvic organs; however, further study and implementation in clinical practice are necessary.

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About the authors

Vladimir G. Grebenkov

Military Medical Academy of S.M. Kirov

Author for correspondence.
Email: grebenkov_89@mail.ru
ORCID iD: 0000-0002-7881-1714
SPIN-code: 4148-0527

аdjunct

Russian Federation, Saint Petersburg

Valery N. Rumyantsev

Military Medical Academy of S.M. Kirov

Email: grebenkov_89@mail.ru
ORCID iD: 0000-0001-7526-6282
SPIN-code: 8166-9820

аdjunct

Russian Federation, Saint Petersburg

Vladimir M. Ivanov

Peter the Great Saint Petersburg Polytechnic University

Email: voliva@rambler.ru
ORCID iD: 0000-0001-8194-2718
SPIN-code: 8738-1873

doctor of physical and mathematical sciences, professor

Russian Federation, Saint Petersburg

Dmitry A. Surov

Military Medical Academy of S.M. Kirov

Email: grebenkov_89@mail.ru
SPIN-code: 5346-1613

doctor of medical sciences, associate professor

Russian Federation, Saint Petersburg

Sergey V. Strelkov

Peter the Great Saint Petersburg Polytechnic University

Email: sergin3d2d@gmail.com
ORCID iD: 0000-0002-5901-0866
SPIN-code: 9357-0837

technical director

Russian Federation, Saint Petersburg

Mikhail S. Korzhuk

Military Medical Academy of S.M. Kirov

Email: gensurg@mail.ru
ORCID iD: 0000-0002-4579-2027
SPIN-code: 1031-6315

doctor of medical sciences, professor

Russian Federation, Saint Petersburg

Oleg V. Balura

Military Medical Academy of S.M. Kirov

Email: grebenkov_89@mail.ru
ORCID iD: 0000-0001-7826-8056
SPIN-code: 9260-9850

candidate of medical sciences

Russian Federation, Saint Petersburg

Andrey V. Svyatnenko

Military Medical Academy of S.M. Kirov; Institute of Emergency Medicine of I.I. Dzhanelidze

Email: svyatnenkoandrei@mail.ru
ORCID iD: 0000-0003-2603-9854
SPIN-code: 8640-6370

doctor-surgeon

Russian Federation, Saint Petersburg; Saint Petersburg

Denis A. Dymnikov

Military Medical Academy of S.M. Kirov

Email: grebenkov_89@mail.ru
ORCID iD: 0000-0003-1644-1014
SPIN-code: 6945-7148

candidate of medical sciences

Russian Federation, Saint Petersburg

Andrey E. Demko

Military Medical Academy of S.M. Kirov; Institute of Emergency Medicine of I.I. Dzhanelidze

Email: demkoandrey@gmail.com
ORCID iD: 0000-0002-5606-288X
SPIN-code: 3399-8762

doctor of medical sciences, professor

Russian Federation, Saint Petersburg; Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Algorithm using augmented reality technology in surgery

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3. Fig. 2. Scheme of the implantation of the invasive fixation system in the anterior superior spine of the ilium

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4. Fig. 3. View of a comparable topographic–anatomical model of a locally advancing rectal tumor (red)

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5. Fig. 4. Stage of intraoperative navigation using augmented reality

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6. Fig. 5. Stage of resection and prosthetics of the external iliac artery and vein

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