Modeling and surgical navigation in treatment of benign ovarian tumors

• Mark F. Dorfman
• Aleksandr S. Gasparov
• Eketerina D. Dubinskaya
• Suren L. Vartanyan
• Evgeniia V. Gubanova
• Sofia F. Dorfman

Abstract

The aim of the study was to investigate effectiveness of preoperative 3D-modeling and surgical navigation in laparoscopic cystectomy in patients of reproductive age.

Material and methods. The study presents the results of a comprehensive examination and treatment of 100 patients with serous ovarian cystadenomas. The main group included 50 patients with serous cystadenomas, who at the stage of preoperative examination, in addition to the standard clinical and laboratory examination, underwent the construction of a 3D-model of the ovary with registration of topography of the tumor and its blood supply areas. The comparison group included 50 patients with serous cystadenomas who underwent preoperative examination according to standard clinical protocols. All patients underwent surgical treatment in the amount of cystectomy by laparoscopic access. To assess the effectiveness of the use of the author’s technology of surgical navigation, clinical and laboratory criteria for trauma were used: intraoperative blood loss, duration of surgery and anesthesia, the patient’s motor activity, restoration of the act of urination and intestinal motility, temperature and pain reactions, indicators of a clinical blood test, as well as biochemical markers of trauma and indicators of ovarian reserve.

The results of statistical and mathematical analysis made it possible to identify 10 significant clinical and laboratory indicators that are informative for assessing the traumatism of surgical intervention. Based on these parameters, a scoring scale was developed.

Conclusion. Personalized modeling and surgical navigation make it possible to perform cystectomy with minimal trauma to healthy ovarian tissue, which leads to a rapid recovery in the postoperative period and significantly reduces the ovarian reserve.

Keywords:operative gynecology; laparoscopy; 3D-modeling; surgical navigation; ultrasonography; cystectomy; ovarian reserve; Fast Track

REFERENCES

1. Nosova Yu.V., Solopova A.E., Asaturova A.V., Tregubova A.V., Kometova V.V., Khabas G.N. The role of intraoperative frozen section analysis in the choice of surgical strategy for ovarian tumors. Akusherstvo i ginekologiya [Obstetrics and Gynecology]. 2020; (9): 120–8. (in Russian)

2. Ministry of Health of the Russian Federation. Clinical guidelines: Diagnosis and treatment of benign ovarian tumors from the standpoint of cancer prevention. Moscow, 2018. (in Russian)

3. Kogan Y. Topical issues of pathogenesis and diagnosis of tumors and ovarian masses. Prakticheskaya meditsina [Practical Medicine]. 2018; 16 (9): 34–9. (in Russian)

4. Adamyan L.V., Sibirskaya E.V., Koltunov I.E., Smal’ T.A., Shutkova A.Yu. Ovarian benign tumors and tumor-like formations of girls and young women. Problemy reproduktsii [Problems of Reproduction]. 2016; 22 (2): 73–7. (in Russian)

5. Management of Suspected Ovarian Masses in Premenopausal Women (Green-top Guideline No. 62).

6. Pavlovich S.V., Yurova M.V., Melkumyan A.G., Frankevich V.E., Chagovets V.V., Khabas G.N. Biomarkers in ovarian neoplasms: opportunities, limitations, and prospects for using in reproductive-aged women. Akusherstvo i ginekologiya [Obstetrics and Gynecology]. 2019; (11): 65–73. (in Russian)

7. Gasparov A.S., Titov D.S., Dubinskaya E.D., Barabanova O.E., Ayrapetyan A.S. Clinical evaluation of traumaticity of different energy types used in the surgical treatment of benign ovarian tumors. Akusherstvo i ginekologiya [Obstetrics and Gynecology]. 2013; (9): 25–9. (in Russian)

8. Borghese G., Coppola F., Raimondo D., Raffone A., Travaglino A., et al. 3D patient-specific virtual models for presurgical planning in patients with recto-sigmoid endometriosis nodules: A pilot study. Medicina (Kaunas). 2022; 58 (1): 86.

9. Alyaev Yu.G., Sirota E.S., E.A. Bezrukov E.A., Ali S.H. 3D-technologies in planning and navigation for laparoscopic interventions in patients with renal and ureteric stones. Urologiya [Urology]. 2019; (4): 9–15. (in Russian)

10. Boedecker C., Huettl F., Saalfeld P., Paschold M., Kneist W., et al. Using virtual 3D-models in surgical planning: workflow of an immersive virtual reality application in liver surgery. Langenbecks Arch Surg. 2021; 406 (3): 911–5.

11. Dorfman M.F., Gasparov A.S., Patsap O.I., Sahakyan M.G., Dorfman S.F. Clinical and morphological features of simple and cellular fibroids. Klinicheskaya i eksperimental’naya morfologiya [Clinical and Experimental Morphology]. 2022; 11 (1): 16–24. (in Russian)

12. Gasparov A.S., Dorfman M.F., Dubinskaya E.D., Vartanyan S.L., Gubanova E.V., Dorfman S.F. Prediction of proliferative activity of uterine leiomyoma. A model for differential diagnosis of usual-type and cellular leiomyoma. Voprosy ginekologii, akusherstva i perinatologii [Problems of Gynecology, Obstetrics and Perinatology]. 2022; 21 (3): 63–9. (in Russian)

13. Dorfman M.F., Gasparov A.S. Modeling and surgical navigation in operative gynecology Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2020; 8 (3): 121–7. (in Russian)

14. Dorfman M.F., Gasparov A.S., Vartanyan S.L., Gubanova E.V., Dorfman S.F. Surgical navigation and 3D modeling in the treatment of uterine fibroids. Voprosy ginekologii, akusherstva i perinatologii [Problems of Gynecology, Obstetrics and Perinatology]. 2022; 21 (5): 21–6. (in Russian)

15. WHO Classification of Tumors. 5th ed. Vol. 4: Female Genital Tumors, 2020.

16. Dorfman M.F., Dorfman S.F., Gasparov A.S., Radzinsky V.E. Method for preparation and performing of surgical operation on small pelvis organs. Certificate of authorship No. 2736800. State Register of Inventions of the Russian Federation. 20.11.2020. (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)