A Novel 3D Light Assisted Drawing (3D-LAD) Method to Aid Intraoperative Reproduction of Osteotomy Lines Surrounding a Bone Tumor During Wide Resection: An Experimental Study

Abstract

Guangyu He,1 Amos Z Dai,2 Vamiq M Mustahsan,1 Christopher L Blum,2 Imin Kao,1 Fazel A Khan2 1Department of Mechanical Engineering, Stony Brook University, Stony Brook, NY, USA; 2Department of Orthopedics, Stony Brook University Hospital, Stony Brook, NY, USACorrespondence: Fazel A Khan, Email [email protected]: Computer navigation and customized 3D-printed jigs improve accuracy during bone tumor resection, but such technologies can be bulky, costly, and require intraoperative radiation, or long lead time to be ready in OR.Methods: We developed a method utilizing a compact, inexpensive, non-X-ray based 3D surface light scanner to provide a visual aid that helps surgeons accurately draw osteotomy lines on the surface of exposed bone to reproduce a well-defined preoperative bone resection plan. We tested the accuracy of the method on 18 sawbones using a distal femur hemimetaphyseal resection model and compared it with a traditional, freehand method.Results: The method significantly reduces the positional error from 2.53 (± 1.13) mm to 1.04 (± 0.43) mm (p< 0.001), and angular error of the front angle from 2.10° (± 0.83°) to 0.80° (± 0.66°) (p=0.001). The method also reduces the mean maximum deviation of the bone resection, with respect to the preoperative path, from 3.75mm to 2.69mm (p=0.003). However, no increased accuracy was observed at the back side of the bone surface where this method would not be expected to provide information.Discussion: In summary, we developed a novel 3D-LAD navigation technology. From the experimental study, we demonstrated that the method can improve the ability of surgeons to accurately draw the preoperative osteotomy lines and perform resection of a primary bone sarcoma, with comparison to traditional methods, using 18 sawbones.Keywords: computer-assist surgery, 3D light assisted drawing, osteotomy lines, structured-light scanning, surgical technique

Keywords

• computer-assist surgery
• 3d light assisted drawing
• osteotomy lines
• structured-light scanning
• surgical technique.