Robotic guidance for en bloc sacrectomy: A case report

S. Samuel Bederman, Gregory Lopez, Tao Ji, Bang H. Hoang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Study Design: Case report of a patient with primary osteosarcoma of the sacrum who underwent en bloc sacrectomy. Objective: To describe a novel approach using robotic guidance for sacral tumor resection. Summary of Background Data: En bloc sacrectomy for aggressive primary malignancies or metastatic tumors of the sacrum can be technically challenging. Although imaging can delineate appropriately planned resection margins, the complex anatomy of the spinopelvic junction poses a challenge for the exact intraoperative execution of the preoperative plan. Methods: The patient was a 22-year-old male who was diagnosed with a primary sacral osteosarcoma. The mass extended to the left sacroiliac joint requiring a transiliac osteotomy. Preoperative robotic-guidance software was used allowing for virtual planning of the transiliac osteotomy. Results: During surgery, the robot was attached and synchronized with the preoperative imaging. Pilot holes were drilled along the planned iliac resection margin. With rigid tubes placed in the left iliac pilot holes, we passed a series of osteotomes parallel to the tubes to the same depth as our drillings and completed our left iliac osteotomy. Negative tumor margins were achieved and the postoperative course was uneventful. Conclusion: We report the first case of robotic-guided en bloc transiliac resection of a primary sacral osteosarcoma with extension to the sacroiliac joint. Robotic guidance for tumor resection can be a useful tool in such challenging surgical procedures to fully resect the tumor, while minimizing disruption of the surrounding healthy anatomy.

Original languageEnglish (US)
Pages (from-to)E1398-E1401
JournalSpine
Volume39
Issue number23
DOIs
StatePublished - 2014

Fingerprint

Robotics
Osteosarcoma
Osteotomy
Sacroiliac Joint
Sacrum
Neoplasms
Anatomy
Software

Keywords

  • Robot assisted
  • Robotic guided
  • Sacrectomy
  • Spinopelvic reconstruction

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Robotic guidance for en bloc sacrectomy : A case report. / Bederman, S. Samuel; Lopez, Gregory; Ji, Tao; Hoang, Bang H.

In: Spine, Vol. 39, No. 23, 2014, p. E1398-E1401.

Research output: Contribution to journalArticle

Bederman, S. Samuel ; Lopez, Gregory ; Ji, Tao ; Hoang, Bang H. / Robotic guidance for en bloc sacrectomy : A case report. In: Spine. 2014 ; Vol. 39, No. 23. pp. E1398-E1401.
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abstract = "Study Design: Case report of a patient with primary osteosarcoma of the sacrum who underwent en bloc sacrectomy. Objective: To describe a novel approach using robotic guidance for sacral tumor resection. Summary of Background Data: En bloc sacrectomy for aggressive primary malignancies or metastatic tumors of the sacrum can be technically challenging. Although imaging can delineate appropriately planned resection margins, the complex anatomy of the spinopelvic junction poses a challenge for the exact intraoperative execution of the preoperative plan. Methods: The patient was a 22-year-old male who was diagnosed with a primary sacral osteosarcoma. The mass extended to the left sacroiliac joint requiring a transiliac osteotomy. Preoperative robotic-guidance software was used allowing for virtual planning of the transiliac osteotomy. Results: During surgery, the robot was attached and synchronized with the preoperative imaging. Pilot holes were drilled along the planned iliac resection margin. With rigid tubes placed in the left iliac pilot holes, we passed a series of osteotomes parallel to the tubes to the same depth as our drillings and completed our left iliac osteotomy. Negative tumor margins were achieved and the postoperative course was uneventful. Conclusion: We report the first case of robotic-guided en bloc transiliac resection of a primary sacral osteosarcoma with extension to the sacroiliac joint. Robotic guidance for tumor resection can be a useful tool in such challenging surgical procedures to fully resect the tumor, while minimizing disruption of the surrounding healthy anatomy.",
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