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By: Sharmaine Estrada

COMPUTER ASSISTED MEDICAL PROCEDURE

COMPUTER ASSISTED SURGERY

Represents a surgical concept and set of methods, that use computer technology for pre-surgical planning, and for guiding or performing surgical interventions.

What is Computer Assisted Surgery?

GENERAL PRINCIPLES

Creating a virtual image of the patient

The most important component for CAS is the

development of an accurate model of the patient. This

can be conducted through a number of medical

imaging technologies including CT, MRI, x-

rays, ultrasound plus many more.

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LOGOAPPLICATIONS

NEUROSURGERY

Telemanipulators 

Allowed a greater development in brain microsurgery ,increased accuracy and precision of the intervention.

• It also opened a new gate to minimally invasive brain surgery.

• reducing the risk of post-surgical morbidity by accidentally damaging adjacent centers.

ORAL AND MAXILLOFACIAL SURGERY

In orthognathic surgery correction of the anomalies of the jaws and skull

•It is also used in implantology where the available bone can be seen and the position, angulation and depth of the implants can be simulated before the surgery.

•During the operation surgeon is guided visually and by sound alerts.• • IGI (Image Guided Implantology) is one of the navigation systems which uses this technology.

ENT SURGERY

•ENT commonly consists of navigating preoperative image data such as CT or cone beam

•CT to assist with locating or avoiding anatomically important regions such as the optical nerve or the opening to the frontal sinuses

• For use in middle-ear surgery there has been some application of robotic surgery due to the requirement for high-precision actions.

ROBOTIC SURGERY

•The application of robotic surgery is widespread in orthopedics, especially in routine interventions, like total hip replacement.

• It is also useful in pre-planning and guiding the correct anatomical position of displaced bone fragments in fractures, allowing a good fixation by osteosynthesis.

•Early CAOS systems include the HipNav, OrthoPilot, and Praxim.

Visceral surgery

• Laparoscopy in abdominal and gynecologic surgery is one of the beneficiaries, allowing surgical robots to perform routine operations, like colecystectomies, or even hysterectomies.

•In cardiac surgery, shared control systems can perform mitral valve replacement or ventricular pacing by small thoracotomies.

•In urology, surgical robots contributed in laparoscopic approaches for pyeloplasty or nephrectomy or prostatic interventions.

RADIOSURGERY

•Radiosurgery is also incorporating advanced robotic systems. •CyberKnife is such a system that has a lightweight linear accelerator mounted on the robotic arm. •It is guided towards tumor processes, using the skeletal structures as a reference system (Stereotactic Radiosurgery System). •During the procedure, real time X-ray is used to accurately position the device before delivering radiation beam.

ADVANTAGES

1. Preoperative diagnostic and a well-defined surgical planning

2.Surgeon can easily assess most of the surgical difficulties and risks and have a clear idea about how to optimize the surgical approach and decrease surgical morbidity.

3.The operation, the computer guidance improves the geometrical accuracy of the surgical gestures and also reduce the redundancy of the surgeon’s acts.

4.This significantly improves ergonomy in the operating theatre, decreases the risk of surgical errors and reduces the operating time.

DISADVANTAGES

New technology and its uses and efficacy have not yet been well established. 

Another disadvantage of these systems is their cost. With a price tag of a million dollars, their cost is nearly prohibitive. 

One of the potential disadvantages identified is a lack of compatible instruments and equipment. Lack of certain instruments increases reliance on tableside assistants to perform part of the surgery

HOSPITALS WITH COMPUTER ASSISTED PROCEDURE IN THE PHILIPPINES

CONCLUSION