[Influence of an auto-motorised optical navigation camera to the surgical workflow in ENT surgery].

BACKGROUND With the application of optical navigation systems an interruption of the line of sight (LOS) between navigation camera and the patient/instrument can occur. The goal of this work is the clinical evaluation of a newly developed system for automatic adjusting of an optical navigation camera (Navigation Camera Assistant, NCA). NCA is a miniature robot, which is able to position the navigation camera autonomously in 2 levels. MATERIAL AND METHODS The influence of the NCA was examined on 128 patients: 55 procedures at the paranasal sinuses and 9 procedures at the temporal bone with the NCA were evaluated and compared with available workflow data of adequate surgeries without NCA. An optical navigation system of the 3 (rd) generation was used. The following parameters were recorded: Preparation time of the system, time of using the system, LOS-interruptions. RESULTS The LOS-interruption decreased in the group of FESS with application of the NCA by 92%, in the group tympanic cavity by 85%. The number of corrective motions of the navigation camera was increased with application of the NCA in the group FESS by 73%, in the group tympanic cavity by 89%. The usage time of navigation increased with the application of the NCA in the group of FESS by 36%, in the group tympanic cavity by 16%. CONCLUSIONS With a motorized navigation camera can be the interruption rate of LOS significantly improved at frontal and lateral skull base. The technical expenditure for installation of the NCA robot is little even during, for this reason there is the potential that this module can be established for the clinical practice.

[1]  Nobuhiko Hata,et al.  Real-time magnetic resonance imaging driven by electromagnetic locator for interventional procedure and endoscopic therapy , 2007, Surgical Endoscopy.

[2]  Nassir Navab,et al.  Online Estimation of the Target Registration Error for n -Ocular Optical Tracking Systems , 2007, MICCAI.

[3]  K Koulechov,et al.  Navigated control in functional endoscopic sinus surgery , 2005, The international journal of medical robotics + computer assisted surgery : MRCAS.

[4]  Mathias Hofer,et al.  Verbesserte Umsetzung der Resektionsgrenzen in der Nasennebenhöhlenchirurgie mit dem navigiert-kontrollierten Shaver , 2006 .

[5]  Thomas Neumuth,et al.  Assessment of technical needs for surgical equipment by surgical process models , 2009, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[6]  W. Freysinger,et al.  Computer assistance for intraoperative navigation in ENT surgery , 2003, Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy.

[7]  T Neumuth,et al.  First clinical evaluation of the navigated controlled drill at the lateral skull base. , 2008, Studies in health technology and informatics.

[8]  Gero Strauß,et al.  Research Paper: Validation of Knowledge Acquisition for Surgical Process Models , 2009, J. Am. Medical Informatics Assoc..