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Updated: Nov 13, 2025

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver

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Computer navigation assisted tumor surgery for internal hemipelvectomy - Early experience.

Akshay Tiwari¹, Anilkumar Yadlapalli¹, Vivek Verma¹

¹Musculoskeletal Surgical Oncology Division, Musculoskeletal Oncology Disease Management Group, Max Institute of Cancer Care, New Delhi, India.

Journal of Clinical Orthopaedics and Trauma

|March 15, 2021

Summary

Computer-assisted tumor surgery (CATS) enhances internal hemipelvectomy outcomes. This technique achieved disease-free margins and preserved critical structures in four Indian patients.

Keywords:

Computer navigation Computer-assisted tumor surgery (CATS)Internal hemipelvectomy Orthopedic oncology Sarcoma

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Area of Science:

Orthopedic Oncology
Surgical Oncology
Medical Technology

Background:

Internal hemipelvectomy is a complex procedure with risks of inadequate margins and critical structure injury.
Computer-assisted tumor surgery (CATS) has emerged as a valuable tool to improve surgical precision.

Purpose of the Study:

To evaluate the feasibility and effectiveness of computer navigation-assisted internal hemipelvectomy in achieving oncological goals.
To report the initial experience of CATS-assisted internal hemipelvectomy in an Indian setting.

Main Methods:

Retrospective analysis of four patients undergoing internal hemipelvectomy with CATS assistance.
Evaluation of surgical parameters including operative time, blood loss, and hospital stay.
Assessment of histopathological margins and preservation of sacral nerve roots.

Main Results:

Mean operative time was 306 minutes, mean blood loss was 1300 ml, and mean hospital stay was 7 days.
All patients achieved disease-free histopathological margins, with an average closest bony margin of 0.9 cm.
Sacral nerve root preservation was achieved in two patients.

Conclusions:

Computer navigation-assisted internal hemipelvectomy is a feasible and effective technique for achieving negative surgical margins.
CATS facilitates the preservation of critical structures during complex internal hemipelvectomy procedures.
This study represents the first report of CATS-assisted internal hemipelvectomy in India.