First tumor resection with 3D-CUT in Chile.

Pelvic tumor resection performed using patient-specific surgical guides.

3D planning of the pelvic tumor resection showing the planned cutting planes.

Preparation and positioning of patient-specific cutting guides for pelvic tumor resection.

Pelvic tumor resection performed following the planned patient-specific cutting planes

Tumor specimen after pelvic tumor resection.

This case marks our first pelvic tumor resection performed in Chile, carried out by Orlando Gabriel Wevar Cruz at the Instituto Traumatológico Dr. Teodoro Gebauer in Santiago.

The challenge came from the tumor location between the ilium and the sacrum, a particularly demanding area where achieving oncological margins while preserving pelvic stability is critical.

Preoperative planning

Using CT imaging, a patient-specific resection plan was developed with five cutting planes and adapted to a posterolateral surgical approach.

Particular attention was given to the orientation of the sacral resections. The planes were designed obliquely to preserve the anterior portion of the sacrum. This approach helps protect nearby visceral structures while maintaining better load sharing and pelvic biomechanics after the resection.

Translating the plan to the operating room

To bring this plan into the operating room, two custom cutting guides were designed:

• one guide for the ilium

• one guide for the sacrum

These guides are connected through a chevron alignment feature, ensuring accurate positioning during surgery.

Guide placement and osteotomies

After exposing the bone, the guides were placed in their unique fitting positions and secured with K-wires.

Some of these K-wires were positioned at the intersections of the cutting planes. They act as mechanical stops to control the depth of the osteotomies and help the surgeon follow the planned resections safely.

The osteotomies were then performed along the planned planes before removing the guides and extracting the tumor specimen.

Supporting complex pelvic tumor surgery

This case illustrates how patient-specific planning and instruments can support surgeons during complex pelvic tumor resections. They help translate the surgical plan accurately in the operating room while preserving key anatomical structures.

A big thank you to Dr. Orlando Wevar and his team for their trust on this first case in Chile.