Computer Assisted Navigation Systems for Hip and Knee Reconstructive Surgery: Evaluation of Traditional Surgical Technique

2001 ◽  
Author(s):  
Anthony M. DiGioia ◽  
Frederic Picard ◽  
Branislav Jaramaz ◽  
David Sell ◽  
James C. Moody ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Patient Outcomes ◽  
Reconstructive Surgery ◽  
Surgical Navigation ◽  
Surgical Techniques ◽  
Measurement Tool ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Assisted Navigation ◽  
Surgical Navigation System

Abstract In this paper we describe a surgical navigation system named HipNav (Hip-Navigation) for THR and KneeNav (Knee-Navigation) for TKR with an emphasis on using these systems as a real time intraoperative measurement tool (these enabling technologies are the surgical toolbox of the future). This approach will permit the direct comparison of patient outcomes with measurable surgical techniques.

Image-Guided Spinal Surgery and Robotics in MIS: Where Are We Now?

2018 ◽  
Vol 1 (2) ◽  
pp. 2
Author(s):  
Chiung Chyi Shen
Keyword(s):  
Pedicle Screw ◽  
Spinal Surgery ◽  
Surgical Navigation ◽  
Improve Patient Safety ◽  
Intraoperative Imaging ◽  
Spinal Instrumentation ◽  
Pedicle Screws ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Image Guided

Use of pedicle screws is widespread in spinal surgery for degenerative, traumatic, and oncological diseases. The conventional technique is based on the recognition of anatomic landmarks, preparation and palpation of cortices of the pedicle under control of an intraoperative C-arm (iC-arm) fluoroscopy. With these conventional methods, the median pedicle screw accuracy ranges from 86.7% to 93.8%, even if perforation rates range from 21.1% to 39.8%.The development of novel intraoperative navigational techniques, commonly referred to as image-guided surgery (IGS), provide simultaneous and multiplanar views of spinal anatomy. IGS technology can increase the accuracy of spinal instrumentation procedures and improve patient safety. These systems, such as fluoroscopy-based image guidance ("virtual fluoroscopy") and computed tomography (CT)-based computer-guidance systems, have sensibly minimized risk of pedicle screw misplacement, with overall perforation rates ranging from between 14.3% and 9.3%, respectively."Virtual fluoroscopy" allows simultaneous two-dimensional (2D) guidance in multiple planes, but does not provide any axial images; quality of images is directly dependent on the resolution of the acquired fluoroscopic projections. Furthermore, computer-assisted surgical navigation systems decrease the reliance on intraoperative imaging, thus reducing the use of intraprocedure ionizing radiation. The major limitation of this technique is related to the variation of the position of the patient from the preoperative CT scan, usually obtained before surgery in a supine position, and the operative position (prone). The next technological evolution is the use of an intraoperative CT (iCT) scan, which would allow us to solve the position-dependent changes, granting a higher accuracy in the navigation system. 

scholarly journals Periacetabular Osteotomy Performed with Imageless Computer-Assisted Navigation: Case Report

2019 ◽  
Vol 2 (1-3) ◽  
pp. 33-39
Author(s):  
Atul F. Kamath ◽  
Rachel R. Mays
Keyword(s):  
Surgical Navigation ◽  
Periacetabular Osteotomy ◽  
Computer Navigation ◽  
Developmental Dysplasia ◽  
Computer Assisted ◽  
Developmental Hip Dysplasia ◽  
Assisted Navigation ◽  
First Case ◽  
Acetabular Fragment ◽  
Pao Surgery

Periacetabular osteotomy (PAO) is an effective surgical treatment for developmental hip dysplasia. The goal of PAO is to reorient the acetabulum to increase acetabular coverage of the femoral head, as well as to reduce contact pressures within the hip joint. The primary challenge of PAO is to accurately achieve the desired acetabular fragment orientation, while maximizing containment and congruency. As key parts of the procedure are performed out of direct field of view of the surgeon, combined with this challenge of precise spatial orientation, there is a potential role for technologies such as surgical navigation. Adjunctive technology may provide information on the orientation of repositioned acetabulum and may offer a useful assist in performing PAO. Here, we present a case of developmental dysplasia of the hip treated via PAO with the addition of an imageless computer navigation device. Surgery was successful, and, at 3 months after procedure, the patient was progressing well. To our best knowledge, this is the first case using imageless computer-assisted navigation in PAO surgery.

scholarly journals Computer-Assisted Navigation Surgery in Oral and Maxillofacial Surgery

2021 ◽  
pp. 841-862
Author(s):  
Shintaro Sukegawa ◽  
Takahiro Kanno
Keyword(s):  
Maxillofacial Surgery ◽  
Computer Assisted Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Navigation Surgery ◽  
Assisted Navigation ◽  
Surgical Options ◽  
Application Of Cas ◽  
Patient Stress

AbstractComputer-assisted surgery (CAS) and navigation offers significant improvements in patient orientation and safety in every facet of our specialty of maxillofacial surgery. Ranging from precisely planned orthognathic procedures to the removal of foreign bodies requiring extremely flexible surgical options, and from minimally invasive dental implantology procedures to radical tumor resections of the skull base, they have made their mark for improving the procedure safety, predictability, and accuracy of surgery and options for intraoperative adaptations. In the future, the application of CAS is expected to further reduce operative risks and surgery time, accompanied by a considerable decrease in patient stress.Navigation systems are effective for delicate and accurate oral and maxillofacial surgery, neurosurgery, otolaryngology, and orthopedic surgery.This section presents an overview of available navigation systems and their applications with a focus on clinical utility and the solutions they offer for problems/challenges in the field of oral and maxillofacial surgery.

A Comparison of Optical and Electromagnetic Computer-Assisted Navigation Systems for Fluoroscopic Targeting

2008 ◽  
Vol 22 (3) ◽  
pp. 190-194 ◽  
Author(s):  
William M Ricci ◽  
Thomas A Russell ◽  
David M Kahler ◽  
Lauralan Terrill-Grisoni ◽  
Patrick Culley
Keyword(s):  
Computer Assisted ◽  
Navigation Systems ◽  
Assisted Navigation

scholarly journals Computer-Assisted Resection and Reconstruction of Pelvic Tumor Sarcoma

Sarcoma ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Pierre-Louis Docquier ◽  
Laurent Paul ◽  
Olivier Cartiaux ◽  
Christian Delloye ◽  
Xavier Banse
Keyword(s):  
Surgical Navigation ◽  
Tumor Resection ◽  
Surgical Margin ◽  
Surgical Oncology ◽  
Tumor Location ◽  
Resection Margins ◽  
Computer Assisted ◽  
Navigation Systems ◽  
First Case ◽  
Saw Blade

Pelvic sarcoma is associated with a relatively poor prognosis, due to the difficulty in obtaining an adequate surgical margin given the complex pelvic anatomy. Magnetic resonance imaging and computerized tomography allow valuable surgical resection planning, but intraoperative localization remains hazardous. Surgical navigation systems could be of great benefit in surgical oncology, especially in difficult tumor location; however, no commercial surgical oncology software is currently available. A customized navigation software was developed and used to perform a synovial sarcoma resection and allograft reconstruction. The software permitted preoperative planning with defined target planes and intraoperative navigation with a free-hand saw blade. The allograft was cut according to the same planes. Histological examination revealed tumor-free resection margins. Allograft fitting to the pelvis of the patient was excellent and allowed stable osteosynthesis. We believe this to be the first case of combined computer-assisted tumor resection and reconstruction with an allograft.

Imageless Navigation Accurately Measures Component Orientation during Total Hip Arthroplasty: A Comparison with Postoperative Radiographs

2019 ◽  
Vol 03 (01) ◽  
pp. 053-058 ◽  
Author(s):  
Wayne Paprosky ◽  
Jeffrey Muir ◽  
Jennifer Sostak
Keyword(s):  
Revision Surgery ◽  
Surgical Navigation ◽  
Absolute Difference ◽  
Computer Assisted ◽  
Leg Length ◽  
Acetabular Cup ◽  
Mean Absolute Difference ◽  
Assisted Navigation ◽  
Navigation Tool ◽  
The Mean

AbstractAccurate placement of acetabular components during total hip arthroplasty (THA) is paramount in ensuring long-term stability. Current methods for monitoring cup position and leg length intraoperatively are lacking due to susceptibility to inaccuracy or prohibitive cost. The purpose of this study was to evaluate the ability of an imageless surgical navigation tool to accurately measure acetabular cup inclination and leg length differential during THA. The authors retrospectively reviewed the medical records of patients who underwent primary or revision THA (posterolateral approach) at their facility with the assistance of computer-assisted navigation between February 2016 and March 2017. Pre- and postoperative radiographs were analyzed for leg length discrepancies and acetabular cup inclination. Radiographic values were compared with intraoperative values provided by the surgical navigation tool. The mean difference between inclination as measured from radiographs (44.4 ± 5.9 degrees) and navigation (43.0 ± 4.4 degrees) was −1.4 ± 4.6 degrees (mean absolute difference: 3.8 ± 2.8 degrees). Seventy-seven percent (48/62) of navigation measurements were within 5 degrees of radiographs. The mean difference between radiographic (7.39 ± 5.67 mm) and navigation (7.44 ± 4.81 mm) measurements of leg length differential was 0.29 ± 4.20 mm (mean absolute difference: 3.20 ± 2.69 mm). Navigation tool measurements were within 5 mm of radiographic values in 85% (39/46) of cases. At 90 days, idiopathic dislocation requiring revision surgery occurred in one patient (1.2%) with one additional patient (1.2%) requiring revision surgery due to a traumatic injury (fall). Computer-assisted navigation provided accurate intraoperative data regarding inclination and changes in leg length and was associated with a low rate of dislocation and revision surgery at 90-day follow-up.

Frameless stereotaxy with scalp-applied fiducial markers for brain biopsy procedures: experience in 218 cases

1999 ◽  
Vol 91 (4) ◽  
pp. 569-576 ◽  
Author(s):  
Gene H. Barnett ◽  
David W. Miller ◽  
Joseph Weisenberger
Keyword(s):  
Surgical Navigation ◽  
Brain Biopsy ◽  
Computer Assisted ◽  
Frameless Stereotaxy ◽  
Complication Rates ◽  
Navigation Systems ◽  
Fiducial Markers ◽  
Content Type ◽  
Wound Breakdown ◽  
Fine Print

Object. The goal of this study was to develop and assess the use and limitations of performing brain biopsy procedures by using image-guided surgical navigation systems (SNSs; that is, frameless stereotactic systems) with scalp-applied fiducial markers.Methods. Two hundred eighteen percutaneous brain biopsies were performed in 213 patients by using a frameless stereotactic SNS that operated with either sonic or optical digitizer technology and scalp-applied fiducial markers for the purpose of registering image space with operating room space. Common neurosurgical and stereotactic instrumentation was adapted for use with a localizing wand, and recently developed target and trajectory guidance software was used.Eight (3.7%) of the 218 biopsy specimens were nondiagnostic; five of these (2.4%) were obtained during procedures in 208 supratentorial lesions and three were obtained during procedures in 10 infratentorial lesions (30%; p < 0.001). Complications related to the biopsy procedure occurred in eight patients (seven of whom had supratentorial lesions and one of whom had an infratentorial lesion, p > 0.25). Five complications were intracerebral hemorrhages (two of which required craniotomy), two were infections, and one was wound breakdown after instillation of intratumoral carmustine following biopsy. There were only three cases of sustained morbidity, and there were two deaths and one delayed deterioration due to disease progression.Two surgeons performed the majority of the procedures (193 cases). The three surgeons who performed more than 10 biopsies had complication rates lower than 5%, whereas two of the remaining four surgeons had complication rates greater than 10% (p = 0.15).Twenty-three additional procedures were performed in conjunction with the biopsies: nine brachytherapies; five computer-assisted endoscopies; four cyst aspirations; two instillations of carmustine; two placements of Ommaya reservoirs; and one craniotomy.Conclusions. Brain biopsy procedures in which guidance is provided by a frameless stereotactic SNS with scalp-applied fiducial markers represents a safe and effective alternative to frame-based stereotactic procedures for supratentorial lesions. There were comparable low rates of morbidity and a high degree of diagnostic success. Strategies for performing posterior fossa biopsies are suggested.

A novel 4 camera multi-stereo tracking system for application in surgical navigation systems

2020 ◽  
Vol 87 (7-8) ◽  
pp. 451-458
Author(s):  
Oliver Gieseler ◽  
Hubert Roth ◽  
Jürgen Wahrburg
Keyword(s):  
Operating Room ◽  
Surgical Navigation ◽  
Tracking System ◽  
Computer Assisted Surgery ◽  
Optical Tracking ◽  
Computer Assisted ◽  
Navigation Systems ◽  
Camera Model ◽  
Camera System ◽  
Industrial Cameras

AbstractIn this paper, we present a novel 4 camera stereo system for application as optical tracking component in navigation systems in computer-assisted surgery. This shall replace a common stereo camera system in several applications. The objective is to provide a tracking component consisting of four single industrial cameras. The system can be built up flexibly in the operating room e. g. at the operating room lamp. The concept is characterized by independent, arbitrary camera mounting poses and demands easy on-site calibration procedures of the camera setup. Following a short introduction describing the environment, motivation and advantages of the new camera system, a simulation of the camera setup and arrangement is depicted in Section 2. From this, we gather important information and parameters for the hardware setup, which is described in Section 3. Section 4 includes the calibration of the cameras. Here, we illustrate the background of camera model and applied calibration procedures, a comparison of calibration results obtained with different calibration programs and a new concept for fast and easy extrinsic calibration.

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