Pelvic nerve visualizations reduce risk in surgery

October 31, 2016
Pelvic nerves made visible: reduced risk in surgery
3D-anatomical atlas. Credit: Delft University of Technology

Every year, thousands of patients suffer nerve damage in the pelvis during rectal surgery, leaving them with incontinence and sexual problems, for example. Noeska Smit has developed a method to make these nerves more visible to surgeons. She will be awarded a doctorate for her work on the subject at TU Delft on Monday, 31 October.


The is anatomically complicated and certain details have not yet been fully mapped out. In just a small area of muscle and bone, there are numerous organs surrounded by , nerves, and connective tissues. Surgeons operating on the pelvis need to have excellent knowledge of its microscopic anatomy. This can help prevent patients developing post-operative problems, such as incontinence or erectile dysfunction. In cancer surgery, good anatomical knowledge also helps ensure that the tumour is fully removed.


"This is why, in my research in the 'Computer Graphics & Visualisation' group, we worked together with the Leiden University Medical Center (LUMC) on a virtual 3-D model of the human pelvis, based on real anatomy",says Noeska Smit. Together with Annelot Kraima, who completed her PhD at Leiden University last year, she made a detailed virtual 3-D anatomical atlas combining all available and new information about the pelvis. "We then put this atlas to use both for educational purposes (to teach anatomy) and to improve pre-operative surgical planning."


"For education, we created an online tool that enables anyone worldwide with an internet connection and a modern browser/PC to view our model. For instance, the tool has already been deployed in an anatomy MOOC (Massive Online Open Course) devised by Leiden University and it has been used by thousands of students already. The tool is free to consult anywhere in the world."

Pelvic nerves made visible: reduced risk in surgery
Credit: Delft University of Technology

In practice

"As for surgical planning, it primarily concerns the treatment of rectal cancer, which affects around 4,000 people every year in the Netherlands alone. Some of the pelvic nerves are so small that they cannot be detected on an MRI scan and are hardly even visible to the surgeon during operations. As a result of this, the nerves are almost always damaged during surgery, often with serious consequences for patients (such as incontinence and sexual dysfunction)."

"Since our model shows these nerves, we can map them to an MRI of the person, so to speak, enabling us to chart these areas of nerves after all."

With the newly-developed tool, the areas of nerves can quickly be made visible. This enables the surgeon to see where the nerves are located relative to the tumour before the operation starts. This is set to prove especially useful for trainee surgeons, but also helps doctors to explain the risks involved in operations to patients.

Explore further: Quality of life meets cure for prostate cancer treatment

More information: Tool 'The Online Anatomical Human':

Related Stories

Quality of life meets cure for prostate cancer treatment

May 11, 2016
Remember the game Operation? You need to carefully remove the body part without nicking the sides or the buzzer will sound.

Surgery for chronic temporal headaches—simplified approach shows good results

April 29, 2016
A modified surgical technique may provide a simpler approach to the surgical treatment for one type of chronic headache, according to an "Ideas and Innovations" paper in the May issue of Plastic and Reconstructive Surgery, ...

Italian teen gets titanium pelvis in world first

February 25, 2015
An Italian teenager suffering from bone cancer has had half his pelvis replaced by a titanium transplant in what medics at Turin's university hospital centre said Wednesday was a world first.

Nerve mapping technology improves surgery for compressed nerves

March 22, 2013
Nerve mapping technology allows surgeons to determine whether surgery has been effective for relieving pressure from compressed nerves, which often function poorly and cause sciatica or pain and weakness in muscles supplied ...

Nerve sparing helps most prostate cancer patients to have same orgasms as before surgery

February 13, 2012
The vast majority of men who have a prostate cancer operation can retain their ability to orgasm if the surgery is carried out without removing the nerves that surround the prostate gland like a hammock, according to a study ...

Recommended for you

Is a common shoulder surgery useless?

November 21, 2017
(HealthDay)—New research casts doubt on the true effectiveness of a common type of surgery used to ease shoulder pain.

Study shows electric bandages can fight biofilm infection, antimicrobial resistance

November 6, 2017
Researchers at The Ohio State University Wexner Medical Center have shown - for the first time - that special bandages using weak electric fields to disrupt bacterial biofilm infection can prevent infections, combat antibiotic ...

Obesity increases incidence, severity, costs of knee dislocations

November 3, 2017
A new study of more than 19,000 knee dislocation cases in the U.S. between 2000 and 2012 provides a painful indication of how the nation's obesity epidemic is changing the risk, severity and cost of a traumatic injury.

Defining optimal opioid pain medication prescription length following surgery

September 27, 2017
A new study led by researchers at the Center for Surgery and Public Health at Brigham and Women's Hospital analyzed opioid prescription data from the Department of Defense Military Health System Data Repository, identifying ...

Is older blood OK to use in a transfusion?

September 27, 2017
(HealthDay)—Using older red blood cells to give transfusions to critically ill patients doesn't appear to affect their risk of dying, Australian researchers report.

One weight-loss surgery shows lasting results

September 21, 2017
(HealthDay)—Obesity surgery can have long-lasting effects on weight and the risk of developing type 2 diabetes and high blood pressure, a new study finds.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.