Medical Research

Clinical and Economic Research Shows Improved Outcomes Using Vector Surgical Devices

Evidence: MarginMarker™ allows “surgeons to better target the area of potential residual disease…”

Medical research shows a compelling need for more accurate specimen orientation and demonstrates the improved outcomes and cost-effectiveness from using MarginMarker.

Evidence: Inaccurate Margin Identification Using Suture

Molina et al. reported a 31% overall disagreement rate between surgeons and pathologists when orienting excised tissue using suture. Altman et al. summarized this, stating “If a pathologist found a positive margin, there was nearly a one in three chance that a surgeon would re-excise the wrong margin.” Arnaout et al. replicated the finding, reporting a 42% overall discordance rate.

Evidence: Fewer, More Accurate Re-excisions Using MarginMarker

Altman et al. recently reported a significantly higher incidence of residual cancer in re-excision specimens oriented using MarginMarker compared to suture. The authors concluded that MarginMarker inks “provide a more accurate 3-dimensional location of the true positive margin.”

Evidence: MarginMarker is Cost-Effective

Researchers using MarginMarker concluded that “surgeon performed intraoperative specimen inking is not only a more accurate method for specimen orientation, but it is also cost-effective.


1. Adsay NV, Basturk O, Saka B, et al. Whipple made simple for surgical pathologists: orientation, dissection, and sampling of pancreaticoduodenectomy specimens for a more practical and accurate evaluation of pancreatic, distal common bile duct, and ampullary tumors. Am J Surg Pathol. 2014;38(4):480-493.
2. Altman AM, Nguyen DD, Johnson B, et al. Intraoperative inking is superior to suture marking for specimen orientation in breast cancer. Breast J. 2020; 26(4):661-667.
3. Arnaout A, Robertson S, Gravel D, Rockwell G, Ayroud Y. The specimen margin assessment technique (SMART) trial: a novel 3-D method of identifying the most accurate method of breast specimen orientation. Paper presented at: Society of Surgical Oncology Annual Cancer Symposium 2016; Boston, MA.
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6. Chand N, Aertssen AMG, Royle GT. Axillary “exclusion”—A successful technique for reducing seroma formation after mastectomy and axillary dissection. Adv Breast Cancer Res. 2013;02(01):1-6.
7. Dooley WC, Parker J. Understanding the mechanisms creating false positive lumpectomy margins. Am J Surg. 2005;190(4):606-608.
8. Evans DB, Farnell MB, Lillemoe KD, Vollmer C Jr, Strasberg SM, Schulick RD. Surgical treatment of resectable and borderline resectable pancreas cancer: expert consensus statement. Ann Surg Oncol. 2009;16(7):1736-1744.
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11. Guidi AJ, Tworek JA, Mais DD, Souers RJ, Blond BJ, Brown RW. Breast specimen processing and reporting with an emphasis on margin evaluation: A college of American Pathologists survey of 866 laboratories. Arch Pathol Lab Med. 2018;142(4):496-506.
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13. Kandel R, Coakley N, Werier J, et al. Surgical margins and handling of soft-tissue sarcoma in extremities: a clinical practice guideline. Curr Oncol. 2013;20(3):e247-54.
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18. MacDonald HR, Silverstein MJ, Mabry H, et al. Local control in ductal carcinoma in situ treated by excision alone: incremental benefit of larger margins. Am J Surg. 2005;190(4):521-525.
19. McCahill LE, Single RM, Aiello Bowles EJ, et al. Variability in reexcision following breast conservation surgery. JAMA. 2012;307(5):467-475.
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22. Molina MA, Snell S, Franceschi D, et al. Breast specimen orientation. Ann Surg Oncol. 2009; 16(2):285-288.
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31. Verbeke CS, Menon KV. Redefining resection margin status in pancreatic cancer. HPB (Oxford). 2009;11(4):282-289.

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