ArticleSurgical endoscopy2018
Advances in stereotactic navigation for pelvic surgery.
Article in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03806244 (Prospective Study of the Feasibility of Stereotactic Navigation in Laparoscopic Surgery for Colorectal Cancer), which is not on this map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Prospective Study of the Feasibility of Stereotactic Navigation in Laparoscopic Surgery for Colorectal Cancer
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A step towards stereotactic navigation during pelvic surgery: 3D nerve topography.Surgical endoscopy · 2018Pooled it
- Pioneering semi-rigid stability: navigating the female pelvis for enhanced precision in binocular vision guidance.Frontiers in surgery · 2026Article
- Early Concepts in CT Image-Guided Robotic Vascular Surgery: The Displacement of Retroperitoneal Structures During Simulated Procedures in a Cadaveric Model.Tomography (Ann Arbor, Mich.) · 2025Article
- Surgical navigation for lateral pelvic lymph node dissection in rectal cancer.Techniques in coloproctology · 2025Review
- Computer-assisted real-time automatic prostate segmentation during TaTME: a single-center feasibility study.Surgical endoscopy · 2021Article
- Future Directions.Clinics in colon and rectal surgery · 2020Review
- Indocyanine green fluorescence-guided laparoscopic surgery, with omental appendices as fluorescent markers for colorectal cancer resection: a pilot study.Surgical endoscopy · 2019Article
- Robotic-assisted stereotactic real-time navigation: initial clinical experience and feasibility for rectal cancer surgery.Techniques in coloproctology · 2019Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStereotactic 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.
methodsFour 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.
resultsAn 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.
conclusionThe 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.
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