3D-Navigation und Projektion in der Leberchirurgie – Ergebnisse einer Pilotstudie

2011 ◽  
Vol 49 (08) ◽  
Author(s):  
K Schymik ◽  
F Rieber ◽  
F Ritter ◽  
C Hansen ◽  
M Mehrwald ◽  
...  
Keyword(s):  
3D Navigation

Noninvasive patient tracker mask for spinal 3D navigation: does the required large-volume 3D scan involve a considerably increased radiation exposure?

2020 ◽  
Vol 33 (6) ◽  
pp. 838-844
Author(s):  
Jan-Helge Klingler ◽  
Ulrich Hubbe ◽  
Christoph Scholz ◽  
Florian Volz ◽  
Marc Hohenhaus ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Image Data ◽  
3D Image ◽  
Flat Panel ◽  
3D Navigation ◽  
Data Set ◽  
Dose Area Product ◽  
Flat Panel Detector ◽  
3D Scan ◽  
Area Product

OBJECTIVEIntraoperative 3D imaging and navigation is increasingly used for minimally invasive spine surgery. A novel, noninvasive patient tracker that is adhered as a mask on the skin for 3D navigation necessitates a larger intraoperative 3D image set for appropriate referencing. This enlarged 3D image data set can be acquired by a state-of-the-art 3D C-arm device that is equipped with a large flat-panel detector. However, the presumably associated higher radiation exposure to the patient has essentially not yet been investigated and is therefore the objective of this study.METHODSPatients were retrospectively included if a thoracolumbar 3D scan was performed intraoperatively between 2016 and 2019 using a 3D C-arm with a large 30 × 30–cm flat-panel detector (3D scan volume 4096 cm3) or a 3D C-arm with a smaller 20 × 20–cm flat-panel detector (3D scan volume 2097 cm3), and the dose area product was available for the 3D scan. Additionally, the fluoroscopy time and the number of fluoroscopic images per 3D scan, as well as the BMI of the patients, were recorded.RESULTSThe authors compared 62 intraoperative thoracolumbar 3D scans using the 3D C-arm with a large flat-panel detector and 12 3D scans using the 3D C-arm with a small flat-panel detector. Overall, the 3D C-arm with a large flat-panel detector required more fluoroscopic images per scan (mean 389.0 ± 8.4 vs 117.0 ± 4.6, p < 0.0001), leading to a significantly higher dose area product (mean 1028.6 ± 767.9 vs 457.1 ± 118.9 cGy × cm2, p = 0.0044).CONCLUSIONSThe novel, noninvasive patient tracker mask facilitates intraoperative 3D navigation while eliminating the need for an additional skin incision with detachment of the autochthonous muscles. However, the use of this patient tracker mask requires a larger intraoperative 3D image data set for accurate registration, resulting in a 2.25 times higher radiation exposure to the patient. The use of the patient tracker mask should thus be based on an individual decision, especially taking into considering the radiation exposure and extent of instrumentation.

scholarly journals Reconstruction of a Combined Frontal Bone and Orbital Roof Defect With Associated Meningoencephalocele Using 3D Modeling and 3D Navigation

2021 ◽  
Vol 6 ◽  
pp. 247275122110233
Author(s):  
Rory C. O’Connor ◽  
Sead Abazi ◽  
Jehuda Soleman ◽  
Florian M. Thieringer
Keyword(s):  
3D Modeling ◽  
Road Traffic ◽  
Treatment Algorithm ◽  
Visual Disturbance ◽  
High Energy ◽  
Frontal Bone ◽  
3D Navigation ◽  
Orbital Roof ◽  
Close Observation ◽  
Orbital Roof Fractures

Introduction: Orbital roof fractures are uncommon and normally associated with high energy trauma in which multiple other injuries are present. Most can be managed non-operatively with close observation. However, in a small proportion the defect is such that it permits the development of a meningoencephalocele, which can cause exophthalmos, a reduction in visual acuity and pain, all of which are unlikely to improve without surgical treatment. In light of their scarcity and the potential of serious risks with surgery that includes meningitis and visual disturbance (or even loss), thorough planning is required so that the meningoencephalocele can be reduced safely and the orbital roof adequately reconstructed. Methods: We report a case of a patient with a frontal bone defect, orbital roof fracture and associated meningoencephalocele that presented years after being involved in a road traffic accident in another country, who complained of a significant headache and orbital pain. The use of 3D modeling to help plan the surgery, and intraoperative 3D navigation to help negotiate the anterior skull base are described along with the reconstruction of the frontal bone and orbital roof using titanium mesh contoured on the 3D model. Conclusions: Although conservative management of orbital roof fractures predominates; those that are symptomatic, have associated neurologic symptoms or pose a risk to the eyesight warrant a surgical approach. The methods of repair, which center around separating the intracranial and intraorbital contents, are described in the context of this patient and previous cases, and a treatment algorithm is proposed.

Design of a Multi-Arm Robot for Mandible Reconstruction Surgery

2014 ◽  
Vol 654 ◽  
pp. 187-190 ◽  
Author(s):  
Hong Hua Zhao ◽  
Jian Ying Tian ◽  
Dong Song Li ◽  
Chang Sheng Ai
Keyword(s):  
Mechanical Design ◽  
The Novel ◽  
Robot System ◽  
Mandible Reconstruction ◽  
3D Navigation ◽  
Reconstruction Surgery ◽  
And Control ◽  
Robotic Surgical System ◽  
Surgical System ◽  
Poor Stability

Clinical treatment for mandible defects is Mandible Reconstruction Surgery (MRS) including bone grafts, distraction osteogenesis and bone tissue engineering, however, MRS is operated by doctors without 3D navigation at present which leads to lots of disadvantages such as bad operational control, low positioning accuracy and poor stability. Therefore, a robotic surgical system was designed to assist surgeons on manipulating. For this study, the robot system was given in brief, then mechanical design and control system of the novel three-arm robot.And experiment results in this study show that the robot works stably and accurately. The development of this medical robot system contributes to the promotion and popularization of the MRS in clinics.

Intraoperative computed tomography registration and electromagnetic neuronavigation for transsphenoidal pituitary surgery: accuracy and time effectiveness

2011 ◽  
Vol 114 (2) ◽  
pp. 329-335 ◽  
Author(s):  
Paula Eboli ◽  
Bob Shafa ◽  
Marc Mayberg
Keyword(s):  
Mr Imaging ◽  
Operating Room ◽  
Navigation System ◽  
Surgical Techniques ◽  
Imaging Data ◽  
3D Navigation ◽  
Closure Time ◽  
Bony Landmarks ◽  
Room Time ◽  
Operating Room Time

Object The authors assessed the feasibility, anatomical accuracy, and cost effectiveness of frameless electromagnetic (EM) neuronavigation in conjunction with portable intraoperative CT (iCT) registration for transsphenoidal adenomectomy (TSA). Methods A prospective database was established for data obtained in 208 consecutive patients who underwent TSA in which the iCT/EM navigation technique was used. Data were compared with those acquired in a retrospective cohort of 65 consecutive patients in whom fluoroscope-assisted TSA had been performed by the same surgeon. All patients in both groups underwent transnasal removal of pituitary adenomas or neuroepithelial cysts, using identical surgical techniques with an operating microscope. In the iCT/EM technique–treated cases, a portable iCT scan was obtained immediately prior to surgery for registration to the EM navigation system, which did not require rigid head fixation. Preexisting (nonnavigation protocol) MR imaging studies were fused with the iCT scans to enable 3D navigation based on MR imaging data. The accuracy of the navigation system was determined in the first 50 iCT/EM cases by visual concordance of the navigation probe location to 5 preselected bony landmarks. For all patients in both cohorts, total operating room time, incision-to-closure time, and relative costs of imaging and surgical procedures were determined from hospital records. Results In every case, iCT registration was successful and preoperative MR images were fused to iCT scans without affecting navigation accuracy. There was 100% concordance between probe tip location and predetermined bony loci in the first 50 cases involving the iCT/EM technique. Total operating room time was significantly less in the iCT/EM cases (mean 108.9 ± 24.3 minutes [208 patients]) compared with the fluoroscopy group (mean 121.1 ± 30.7 minutes [65 patients]; p < 0.001). Similarly, incision-to-closure time was significantly less for the iCT/EM cases (mean 61.3 ± 18.2 minutes) than for the fluoroscopy cases (mean 71.75 ± 19.0 minutes; p < 0.001). Relative overall costs for iCT/EM technique and intraoperative C-arm fluoroscopy were comparable; increased costs for navigation equipment were offset by savings in operating room costs for shorter procedures. Conclusions The use of iCT/MR imaging–guided neuronavigation for transsphenoidal surgery is a time-effective, cost-efficient, safe, and technically beneficial technique.

scholarly journals Sa1943 COECAL INTUBATION TIME WITH THE 3D NAVIGATION SYSTEM SCOPEPILOT VERSUS STANDARD COLONOSCOPY

2018 ◽  
Vol 87 (6) ◽  
pp. AB259
Author(s):  
Fabian Straulino ◽  
Alexander Genthner ◽  
Sibel Kangalli ◽  
Natalja Tscherwinski ◽  
Axel Eickhoff
Keyword(s):  
Navigation System ◽  
Intubation Time ◽  
3D Navigation ◽  
Standard Colonoscopy

scholarly journals Gender-specific risk of complications in catheter ablation for atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Plasek ◽  
J Plasek ◽  
P Peichl ◽  
D Wichterle ◽  
R Cihak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Body Height ◽  
Left Ventricular ◽  
Navigation Systems ◽  
3D Navigation ◽  
Bundle Branch Block ◽  
Specific Risk ◽  
Gender Specific

Abstract Background Catheter ablation is an established treatment modality for atrial fibrillation (AF). The risk of procedural complications is not negligible. Some studies suggested that female patients have a higher risk of complications. Purpose To identify gender-specific predictors of major complications (MCs) in patients undergoing catheter ablation for AF in a tertiary ablation centre. Methods A total of 4733 catheter ablations for AF (65% paroxysmal, 26% repeated procedures) were performed at our centre between January 2006 and August 2018. Patients (71% males) aged 60±10 years and had body mass index of 29±4 kg/m2 at the time of the procedure. Radiofrequency point-by-point ablation was employed in 96.3% procedures with the use of 3D navigation systems and facilitated by intracardiac echocardiography. Pulmonary vein isolation was mandatory; cavotricuspid isthmus and left atrial substrate ablation were performed in 22% and 38% procedures, respectively. MCs were defined as those that resulted in permanent injury, required intervention or prolonged hospitalization. Variables were assessed by uni- and multivariate analysis, two-sided α&lt;0.05 was considered significant. Results A total of 160 (3.4%) MCs were detected - 60 (4.4%) in females and 100 (2.9%) in males (P=0.012). Both lower body height and the presence of bundle branch block (BBB) were associated with MCs only in females; for left bundle branch block (LBBB), the effect size was higher. On the contrary, higher left ventricular end-diastolic diameter (LVEDd) and persistent AF were associated with MCs in males (Table). Conclusion Females have a higher risk of MCs during catheter ablation for AF. Body height, AF type, BBB, and LVEDd may belong among gender-specific risk factors for MCs in AF ablation procedures. Whether BBB and LVEDd represent true risk factors warrants a validation in further studies. Funding Acknowledgement Type of funding source: None

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