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(MSc by Research) Intra-Operative Navigation Through Augmented Reality for Sarcoma Surgery

Introduction and Background 

Sarcomas are malignant tumours of mesenchymal origin which arise from connective tissues in any region of the body. Sarcomas are aggressive and difficult to diagnose. Disease can be resistant to current neoadjuvant chemoradiotherapy, and surgical management is recommended. Modern practice is to strive for limb salvage surgery. By the time of treatment sarcomas are often large and morphologically complex, invading neighbouring local tissues or engulfing neurovascular structures. Surgical resection is therefore technically challenging and functional outcomes are variable. 

Computer aided navigation offers a solution to delineate sarcomas intraoperatively with the proposed benefits of enhanced precision and real time feedback in areas of complex anatomy. Augmented reality is a novel navigation technique which mixes digital information with real world stimuli to create a mixed reality environment which the surgeon can interact with. In practical terms this new technology allows us to project holograms of patient specific disease onto the patient’s own body intraoperatively. 

Aims of the project 

The successful candidate will work within the Oxford Sarcoma Group, for 12 months, collecting and analysing data from a prospective observational study of navigated sarcoma resection utilising the Microsoft HoloLens V2. Primary outcomes will include resection margins and patient reported functional outcome measures. Secondary outcomes will evaluate the role of this technology in patient education and post graduate surgical training including in a global surgery context. 

Supervision 

The appointed candidate will be supervised by Prof T Cosker, Clinical Lead for Oxford Sarcoma and Director of Surgical Anatomy, Nuffield Department of Surgery, University of Oxford. On a day-to-day basis the candidate will work under the direction of the Sarcoma research fellow. 

Interested candidates should email Professor Cosker prior to application.

References 

Mor et al. 3D-SARC: A Pilot Study Testing the Use of a 3D Augmented-Reality Model with Conventional Imaging as a Preoperative Assessment Tool for Surgical Resection of Retroperitoneal Sarcoma. Ann Surg Oncol. 2024 Jun 19. doi: 10.1245/s10434-024-15634-w. 

Rankin et al. Surgical Advances in Osteosarcoma. Cancers (Basel). 2021 Jan 21;13(3):388. 

Bruschi et al. What to choose in bone tumour resections? Patient specific instrumentation versus surgical navigation: a systematic review. J Bone Oncol. 2023 Sep 13;42:100503 

Williams et al. Augmented reality in surgical training: a systematic review, Postgraduate Medical Journal, Volume 96, Issue 1139, September 2020, Pages 537–542