Bespoke surgical guides bring innovative treatment for sarcoma cancer patients

A pioneering new way of operating on patients with bone cancer is taking place in Oxford, thanks to the surgical and technical teams at the Nuffield Orthopaedic Centre (NOC) and the support of Oxford Hospitals Charity.

The surgical resection of bone sarcomas – where a tumour extends in or through a bone – is a highly complex field. And the Sarcoma Unit at the NOC is one of only five specialist centres in the UK with expertise in this area.

Surgical cutting guides are emerging as an innovative new tool in this field, and when the NOC team requested funding of £60,000 to introduce this new technology to our hospitals our Trustees were impressed by the possibilities and delighted to approve funding. The two-year trial, which will include 20 bone cancer operations, is now underway.

Surgeon, Ather Siddiqi, explains: ‘An exact replica of the bone and tumour is created, bespoke to each patient, by merging their CT and MRI scans, then manufacturing it, in-house in a 3D printing facility. ‘This replica helps the surgeon visualise and plan each operation and is also used to create cutting guides that are an exact fit for the individual patient’s anatomy and shape of the tumour.

‘The guides are then also manufactured by 3D printing in sterilisable, bio-compatible materials, before being used for millimetre precision cutting during surgery

'These predetermine the surgeons’ cuts of the bone, preserving the maximum amount of healthy tissue, while providing a safe margin around the tumour. It allows us to only remove what is absolutely necessary – which makes a huge difference to outcomes.’

Hazel Murray, Head of Programme at Oxford Hospitals Charity, adds: ‘The team has told us that 16 cases have now successfully taken place, and these guides helped with pre-surgical planning as well as reducing the patients’ loss of blood and time in theatre, and making the recovery time quicker. It’s a real advance.’

The work is also providing important research in the field, with the early results recently presented at the biggest orthopaedic sarcoma conference in Europe, as well as the International Society of Limb Salvage Surgery (ISOLS) in Los Angeles, USA. With the help of the trial the Oxford Sarcoma Service has pioneered the routine use of this technology in their field and after the very encouraging results from Oxford, other trusts are now employing this technology.

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