| Title |
Advances in stereotactic navigation for pelvic surgery
|
|---|---|
| Published in |
Surgical Endoscopy, December 2017
|
| DOI | 10.1007/s00464-017-5968-0 |
| Pubmed ID | |
| Authors |
A. R. Wijsmuller, L. G. C. Romagnolo, V. Agnus, C. Giraudeau, A. G. F. Melani, B. Dallemagne, J. Marescaux |
| Abstract |
Stereotactic navigation could improve the quality of surgery for rectal cancer. Critical challenges related to soft tissue stereotactic pelvic navigation include the potential difference in patient anatomy between intraoperative lithotomy and preoperative supine position for imaging. The objective of this study was to determine the difference in patient anatomy, sacral tilt, and skin fiducial position between these different patient positions and to investigate the feasibility and optimal set-up for stereotactic pelvic navigation. Four consecutive human anatomical specimens were submitted to repeated CT-scans in a supine and several degrees of lithotomy position. Patient anatomy, sacral tilt, and skin fiducial position were compared by means of an image computing platform. In two specimens, a 10-degree wedge was introduced to reduce the natural tilt of the sacrum during the shift from supine to lithotomy position. A simulation of laparoscopic and transanal surgical procedures was performed to assess the accuracy of the stereotactic navigation. An up-to-supracentimetric change in patient anatomy was noted between different patient positions. This observation was minimized through the application of a wedge. When switching from supine to another position, sacral retroversion occurred independent of the use of a wedge. There was considerable skin fiducial motion between different positions. Accurate stereotactic navigation was obtained with the least registration error (1.9 mm) when the position of the anatomical specimen was registered in a supine position with straight legs, without pneumoperitoneum, using a conventional CT-scan with an identical specimen positioning. The change in patient anatomy is small during the sacral tilt induced by positional changes when using a 10-degree wedge, allowing for an accurate stereotactic surgical navigation. This opens up new promising opportunities to increase the quality of surgery for rectal cancer cases where it is difficult or impossible to identify and dissect along the anatomical planes. |
X Demographics
The data shown below were collected from the profiles of 20 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 5 | 25% |
| Spain | 2 | 10% |
| United Kingdom | 1 | 5% |
| Canada | 1 | 5% |
| Ecuador | 1 | 5% |
| India | 1 | 5% |
| Brazil | 1 | 5% |
| Unknown | 8 | 40% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 10 | 50% |
| Practitioners (doctors, other healthcare professionals) | 5 | 25% |
| Science communicators (journalists, bloggers, editors) | 3 | 15% |
| Scientists | 2 | 10% |
Mendeley readers
The data shown below were compiled from readership statistics for 24 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 24 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 6 | 25% |
| Student > Ph. D. Student | 5 | 21% |
| Student > Master | 3 | 13% |
| Other | 2 | 8% |
| Researcher | 2 | 8% |
| Other | 0 | 0% |
| Unknown | 6 | 25% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 67% |
| Computer Science | 1 | 4% |
| Nursing and Health Professions | 1 | 4% |
| Unknown | 6 | 25% |
Attention Score in Context
This research output has an Altmetric Attention Score of 11. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 June 2018.
All research outputs
#3,047,809
of 23,577,761 outputs
Outputs from Surgical Endoscopy
#377
of 6,259 outputs
Outputs of similar age
#68,196
of 442,941 outputs
Outputs of similar age from Surgical Endoscopy
#22
of 164 outputs
Altmetric has tracked 23,577,761 research outputs across all sources so far. Compared to these this one has done well and is in the 87th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,259 research outputs from this source. They receive a mean Attention Score of 4.1. This one has done particularly well, scoring higher than 93% of its peers.
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We're also able to compare this research output to 164 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.