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Augmented Reality-Assisted Placement of Surgical Guides and Osteotomy Execution for Pelvic Tumour Resections: A
Tanya Fernández-Fernández1, Javier Orozco-Martínez1, Amaia Iribar-Zabala2
1Department of Orthopaedic Surgery and Traumatology-Musculoskeletal Oncology Division, Hospital General Universitario Gregorio Marañón, Dr. Esquerdo 46, 28007 Madrid, Spain.
Cancers
|July 12, 2025
Summary
Augmented reality (AR) with head-mounted displays (HMDs) accurately guides patient-specific instrument (PSI) placement and osteotomies in pelvic tumor resections, improving surgical precision with minimal workflow impact.
Area of Science:
- Surgical Technology
- Medical Imaging
- Augmented Reality
Background:
- Pelvic tumor resections require precise instrument placement and osteotomies.
- Current methods may face challenges in accuracy and workflow efficiency.
- Augmented reality (AR) offers potential for enhanced surgical guidance.
Purpose of the Study:
- To evaluate the accuracy and feasibility of AR guidance using head-mounted displays (HMDs) for patient-specific instrument (PSI) placement.
- To assess AR's impact on osteotomy performance in pelvic tumor resections.
- To analyze user perception and workflow efficiency of the AR system.
Main Methods:
- A pre-clinical study using 10 3D-printed pelvic phantoms.
- Custom patient-specific instruments (PSIs) designed for supraacetabular, symphysial, and ischial regions.
- HoloLens 2 HMD with an AR application for guiding PSI placement and osteotomies, followed by CT analysis.
Main Results:
- Mean angular deviation for PSI placement was 2.20°, with a mean distance error of 1.19 mm.
- Osteotomies showed a mean angular deviation of 3.73°, within the 5° threshold.
- AR guidance added minimal time (<2 minutes) per procedure, with positive user feedback on usability.
Conclusions:
- AR integrated with HMDs is a feasible and accurate technology for improving PSI placement and osteotomy performance in pelvic tumor resections.
- The system offers reliable guidance, even with PSI failure, enhancing accuracy with minimal workflow disruption.
- Further validation in cadaveric models is recommended for clinical applicability.
