Pelvic Tumor Resection Using Patient-Specific Guides

3D planning showing patient-specific cutting guides and planned pelvic osteotomies.

Intraoperative view during pelvic tumor resection.

Intraoperative handling of the resected pelvic bone segment.

Intraoperative view of implant placement during pelvic reconstruction.

Postoperative pelvic X-ray following tumor resection and reconstruction.

There are cases where precision goes beyond expectations.

In this complex pelvic resection, the level of congruence achieved at the obturator foramen is simply remarkable, clearly visible on the postoperative radiograph.

On the iliac side, this congruence is more subtle on imaging, yet it is no less real and remains perfectly consistent with the initial planning.

Such a level of alignment is never incidental: it reflects an exceptionally close match between the preoperative strategy and the surgical execution.

Pelvic tumor resection: clinical case and planning

This procedure, performed by Dr Jean-Camille Mattei, was carried out using patient-specific cutting guides (3D-CUT ONCO), designed from a planning process combining CT and MRI data.

The objective was to ensure a 7 mm safety margin while preserving as much bone structure as possible in an anatomically complex pelvic region.

The validated planning included multiple cutting planes on the ilium, as well as one cutting plane on the ischium and one on the pubis, using a lateral approach.

Bone–guide congruence as a key indicator

The guides were positioned in strict accordance with the planning, with particular attention paid to stability and bone–guide congruence. The distal guide, composed of two parts (pubic and ischial), was separated intraoperatively following the predefined sequence.

The fixation pins also acted as mechanical stops, helping to control cutting depths and ensure accurate execution of the planned cutting planes.

Reconstruction and anatomical continuity

The accuracy of the osteotomies allowed preservation of an osseous geometry compatible with implant-based reconstruction, aimed at restoring the anatomical continuity of the pelvis.

This step is part of a comprehensive surgical approach, in which the quality of planning and resection directly determines the reconstructive possibilities.