report of a new passive, optical surgical navigation system for endoscopic sinus surgery martin j....
TRANSCRIPT
![Page 1: Report of a New Passive, Optical Surgical Navigation System for Endoscopic Sinus Surgery Martin J. Citardi, M.D. Saint Louis University Department of Otolaryngology](https://reader035.vdocuments.net/reader035/viewer/2022070413/5697bfc21a28abf838ca4ff9/html5/thumbnails/1.jpg)
Report of a New Passive, Optical Surgical Navigation
System for Endoscopic Sinus Surgery
Martin J. Citardi, M.D.
Saint Louis University
Department of Otolaryngology
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Computer-Aided Sinus Surgery
Anatomic complexityLimitations of endoscopic visualizationSurgical navigation systems
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SAVANT
New CAS platformCbyon (Palo Alto, CA)Optical tracking systemWindows NT platformReport of initial FDA
trial
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Methods
Prospective trial (FDA protocol)1 mm axial CT transferred to workstation
via networkVisual estimates of registration accuracySurgeon’s questionnaires
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SAVANT
Pre-release software version (0.8-0.9)Headset reference frameSemiautomatic registrationPassive (wireless) instruments
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Semiautomatic Registration
Headset at time of CT scan and OR
Registration to points on headset
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SAVANT Instrumentation
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Results
17 patients enrolledIndication: chronic rhinosinusitisFailure to achieve acceptable registration
in 1 instanceSurgery canceled in 1 instance (asthma
exacerbation)15 patients completed protocol
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Results
Registration accuracy estimates at 4 points in surgical volume
Distribution of estimates:
0-2 mm. 38 (63.3%)
2-4 mm. 14 (23.3%)
4-6 mm. 3 (5.0%)
>6 mm. 5 (8.3%)
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Subjective Evaluation
Relatively easy set-up, especially for a developmental system
Good user interfaceExcellent monitorExcellent technical support
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Representative Images
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Headset Issues
Modified Anatomark headset (designed for co-registration of MR/CT scans)
DRF designEar piece calibrationFully automatic
registration anticipated
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Advantages
Even semiautomatic registration rapidPassive (wireless) trackingExcellent user interfaceAutomatic registration in development
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Disadvantages
Headset design issuesSemiautomatic registration
Note: Technical solutions are on the horizon…
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Summary
Preliminary report of a new CAS system for sinus surgery
Promising technological platformSystem limitations identified; technical
solutions in early implementation phaseAdditional reports forthcoming…