Stereotactic navigation for TAMIS-TME: opening the gateway to frameless, image-guided abdominal and pelvic surgery

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• 作者：Sam Atallah ; George Nassif ; Sergio Larach
• 关键词：TAMIS ; Stereotactic surgery ; Transanal stereotaxy ; Transanal TME ; Image ; guided surgery ; Navigation
• 刊名：Surgical Endoscopy
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：29
• 期：1
• 页码：207-211
• 全文大小：1,236 KB
• 参考文献：1. Schols RM, Bouvy ND, van Dam RM, Stassen LP (2013) Advanced intraoperative imaging methods for laparoscopic anatomy navigation: an overview. Surg Endosc 27(6):1851-859. doi:10.1007/s00464-012-2701-x CrossRef
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  12. Sylla P, Bordeianou LG, Berger D, Han KS, Lauwers GY, Sahani DV, Sbeih MA, Lacy AM, Rattner DW (2013) A pilot study of natural orifice transanal endoscopic total mesorectal excision with laparoscopic assistance for rectal cancer. Surg Endosc 27(9):3396-405 CrossRef
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Gynecology
  Gastroenterology
  Hepatology
  Proctology
  Abdominal Surgery
  
• 出版者：Springer New York
• ISSN：1432-2218

文摘

Background Frameless stereotaxy is an established method for real-time image-guided surgical navigation in neurological surgery. Though this is capable of providing sub-millimeter accuracy, it has not been used by other surgical specialists. Methods and procedure A patient with locally advanced, distal rectal cancer and tumor abutting the prostate was selected for transanal TME using TAMIS, with intra-operative CT-guided navigation to ensure an R0 resection. Results The use of stereotactic TAMIS-TME was successfully performed with an accuracy of ±4?mm. The surgical specimen revealed an R0 resection, and this new approach aided in achieving adequate resection margins. Conclusion This is the first report of the use of frameless stereotactic navigation beyond the scope of neurosurgery. Stereotactic navigation for transanal total mesorectal excision is shown to be feasible. Stereotactic navigation may potentially be applied toward other pelvic and fixed abdominal organs, thereby opening the gateway for a broader use by the general surgeon.