Computer Aided Surgery最新文献

{"title":"Navigated percutaneous lumbosacral interbody fusion: a feasibility study.","authors":"Yu Wang,&nbsp;Dang Q S Le,&nbsp;Haisheng Li,&nbsp;Miao Wang,&nbsp;Cody Eric Bünger","doi":"10.3109/10929088.2011.559412","DOIUrl":"https://doi.org/10.3109/10929088.2011.559412","url":null,"abstract":"<p><strong>Introduction: </strong>Advances in surgical navigation have opened new possibilities for lumbosacral interbody fusion procedures. We have designed a novel navigated surgical method, Navigated Percutaneous Lumbosacral Interbody Fusion (NPLSIF), that enables lumbosacral discectomy and bone grafting to be performed percutaneously and safely.</p><p><strong>Methods: </strong>To prove that NPLSIF is feasible from an anatomical perspective, it was simulated on 3D models of the lumbosacral spine created using CT data from 60 patients. Feasibility would be verified if both the working corridor and the S1 pedicle screw could be accommodated in the sacral ala without overlapping and without penetrating either the spinal canal or the anterior or upper sacral wall. In addition, the discectomy that could be achieved using NPLSIF was evaluated, and a surgical experiment was performed using a plastic torso model.</p><p><strong>Results: </strong>The 3D modeling and surgical simulation were successfully completed in all cases. The feasibility of the NPLSIF approach was verified in every case, i.e., both the working corridor and the S1 pedicle screw were accommodated in the sacral ala without overlapping and without penetrating either the spinal canal or the anterior or upper sacral wall. The mean ratio of the area of discectomy that could be achieved by NPLSIF to the total area of the lumbosacral disc was 0.721 ±  0.065 (range: 0.57-0.894), 0.956  ±  0.045 (range: 0.8-1.0) and 0.945  ±  0.058 (range: 0.813-1.0) in the axial, coronal and sagittal planes, respectively. NPLSIF was also successfully executed on the plastic torso model. Preoperative planning on the navigation workstation took 5 minutes and each intraoperative CT scan took 30 seconds. Locating the entry point of the working corridor according to the preoperative plan took 3 minutes. Postoperative CT images and direct viewing of the plastic model revealed no penetration of the spinal canal or sacral wall.</p><p><strong>Conclusion: </strong>The feasibility of Navigated Percutaneous Lumbosacral Interbody Fusion (NPLSIF) was verified from an anatomical perspective. We also demonstrated that an adequate discectomy can be achieved using the procedure. Cadaveric experiments and clinical trials are needed to further evaluate the efficacy and efficiency of NPLSIF.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"16 3","pages":"135-42"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2011.559412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29722413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and diagnostic yield of CT-guided stereotactic liver biopsy of primary and secondary liver tumors.","authors":"Peter Schullian,&nbsp;Gerlig Widmann,&nbsp;Thomas Bob Lang,&nbsp;Martin Knoflach,&nbsp;Reto Bale","doi":"10.3109/10929088.2011.578367","DOIUrl":"https://doi.org/10.3109/10929088.2011.578367","url":null,"abstract":"<p><strong>Objective: </strong>CT-guided biopsy still plays a decisive role in the management of liver tumors, especially if the lesions are not visible or accessible by ultrasound. As CT-guided stereotaxy appears to be a very accurate targeting technique, the aim of this study was to evaluate the targeting accuracy, diagnostic yield, and complications of CT-guided stereotactic liver biopsy of primary and secondary liver tumors.</p><p><strong>Methods and materials: </strong>Prior to stereotactic liver biopsy, patients under general anesthesia were immobilized using a vacuum cushion. Respiratory motion was controlled by temporary disconnections of the endotracheal tube. An optical-based navigation system was used for 3D trajectory planning and placement of a 15-G coaxial needle via a stereotactic aiming device. The histological samples were obtained using a 16-G Tru-Cut(™) biopsy needle system. For evaluation of targeting accuracy the control CT image with the needles in place was fused with the planning CT image. The lateral error at the tip and skin entry point and the angular error were calculated. In addition, the skin-to-liver-surface (SL) distance, the needle-to-liver-surface (NL) angle, and the presence of liver cirrhosis were evaluated. The diagnostic yield was evaluated by histological reports from the institutional pathologists.</p><p><strong>Results: </strong>The median lateral error was 2.5 mm (range: 0-6.5 mm) at the needle entry point and 3.2 mm (range: 0.01-9.4 mm) at the needle tip. The median angular error was 1.06° (range: 0-6.64°). Liver cirrhosis, NL angle and SL distance showed no significant impact on the targeting accuracy. Forty-five of the 46 liver biopsies (97.8%) were diagnostic according to the histological reports. No puncture-related complications such as bleeding or perforation of intestinal organs or lung tissue were recorded.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":" ","pages":"181-7"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2011.578367","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40110326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized higher dose of 70-75 Gy using five-fraction robotic stereotactic radiotherapy for non-small-cell lung cancer: a feasibility study.","authors":"W T Brown,&nbsp;F Fayad,&nbsp;J Hevezi,&nbsp;J Fowler,&nbsp;M I Monterroso,&nbsp;S Garcia,&nbsp;A Medina,&nbsp;J Schwade","doi":"10.3109/10929088.2010.537483","DOIUrl":"https://doi.org/10.3109/10929088.2010.537483","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether robotic stereotactic radiotherapy of 70-75 Gy delivered in five fractions results in an improved therapeutic ratio, compared with three fractions, in the treatment of peripheral non-small-cell lung cancer (NSCLC), in which case doses of up to 85 Gy in five fractions may be feasible.</p><p><strong>Materials and methods: </strong>Between December 2006 and May 2010, 20 patients (9 female, 11 male, aged 65 to 88) were treated using the CyberKnife® Robotic Radiosurgery System for NSCLC with doses ranging from 67 Gy to 75 Gy based on location, histopathological type, grade of histopathological differentiation, tumor diameter/volume, and normal tissue constraints, with the doses being delivered in five fractions over 5 to 8 days. Tumor diameters ranged from 1.5 cm to 3.4 cm (median: 2.5 cm). Patients with Stage I to IV NSCLC were treated, and the results and observations were analyzed for clinical characteristics and outcomes including toxicity. All patients, except one who had refused surgery, had co-morbid conditions that precluded a lobectomy.</p><p><strong>Results: </strong>Twenty patients were followed every three months by positron emission tomography/computed tomography (PET/CT). Mean follow-up was 23 months (range: four to 58 months). Local control was achieved in all treated tumors. Three patients expired, and three developed new regional metastases, none of which was within the planning target volume (PTV). The remainder of the patients demonstrated no evidence of recurrence or continued growth detectable by PET/CT. There was no toxicity above Grade 1.</p><p><strong>Conclusions: </strong>It is feasible to treat peripheral NSCLC with individualized maximal tolerable doses ranging from 67 Gy to 75 Gy in five fractions chosen on the basis of location, histopathological type, grade of histopathological differentiation, tumor diameter/volume, and normal tissue constraints.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"16 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2010.537483","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29569684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registration of CT to 3D ultrasound using near-field fiducial localization: A feasibility study.","authors":"Raoul Kingma,&nbsp;Robert N Rohling,&nbsp;Chris Nguan","doi":"10.3109/10929088.2011.556181","DOIUrl":"https://doi.org/10.3109/10929088.2011.556181","url":null,"abstract":"<p><strong>Objective: </strong>Registration of ultrasound to computed tomography (CT) images is used in several image-guided procedures, including laparoscopic surgery and radiation therapy. Conventional approaches use an external tracker calibrated to the ultrasound transducer and CT system, but several calibration steps are required. Registration can also be performed by aligning image features between modalities, but differences in feature depiction make matching difficult and initial approximate alignment is often needed. Registration using fiducials is a simpler approach but is limited by the need to implant fiducials in the anatomical region of interest so they are visible to both ultrasound and CT. This paper investigates the feasibility of using fiducials near the skin surface, and whether such fiducials can be sufficiently localized in the very near field of a 3D ultrasound transducer without significantly degrading image quality. This approach can also be used as an initialization step for feature-based registration techniques.</p><p><strong>Materials and methods: </strong>A stand-off pad containing fiducials (n > 3) was constructed using polyvinyl chloride and steel ball fiducials that are visible in both 3D ultrasound and CT images. Experiments on phantoms were performed to assess image quality and registration errors. Controlled variables included pad thickness and ultrasound imaging parameters. Initial tests were also conducted of a potential application in partial nephrectomy surgery.</p><p><strong>Results: </strong>Image quality was degraded by an average of 6-11-13% (elevational-axial-lateral) in resolution of point targets and 5% in lesion contrast. Average fiducial localization error was 1.34 mm (axial) to 2.38 mm (lateral and elevational); average fiducial registration error (FRE) was 0.46 mm (axial), 1.08 mm (lateral) and 0.90 mm (elevational); and average total registration error (TRE) was 1.84 mm (axial), 0.89 mm (lateral) and 3.31 mm (elevational). Clinical results showed a similar FRE to that in the phantom study, but with an average TRE of 14.04 mm (over three patients). Ultimate alignment of the organ boundaries was affected mainly by motion from respiration.</p><p><strong>Conclusions: </strong>The small loss of image quality from the fiducial stand-off pad and the minimal inconvenience of using the pad at the time of the CT scan may be a worthwhile trade-off for purposes of registration since the pad provides a registration accuracy of several millimeters while still allowing subsequent feature-based registration. Future research will focus on using the registration from the fiducial stand-off pad for deformable feature-based registration of 3D ultrasound to CT for tumor localization in renal surgery.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"16 2","pages":"54-70"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2011.556181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29672991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staged image guided robotic radiosurgery for optic nerve sheath meningiomas.","authors":"Pantaleo Romanelli,&nbsp;Livia Bianchi,&nbsp;Alexander Muacevic,&nbsp;Giancarlo Beltramo","doi":"10.3109/10929088.2011.622615","DOIUrl":"https://doi.org/10.3109/10929088.2011.622615","url":null,"abstract":"<p><strong>Objective: </strong>Optic nerve sheath meningiomas (ONSMs) represent the most challenging lesions involving the optic pathways: Microsurgery is not indicated and classical single-stage radiosurgery appears to be too risky due to the expected destruction of the common blood supply with consequent loss of vision. Staged radiosurgery might be one treatment option because it exploits the ability of normal tissues to repair sub-lethal radiation-induced damage, offering a chance to control tumor growth while sparing function. Staged robotic radiosurgery was offered to 5 patients harboring ONSMs with the aim of sparing vision while achieving local growth control.</p><p><strong>Patients and methods: </strong>Five patients with ONSM presenting with visual field deficits and loss of visual acuity were treated with staged CyberKnife radiosurgery, receiving 20 Gy in 4 stages (5 Gy per stage). Treatment planning was based on contrast-enhanced thin-slice CT (1.25 mm thickness for the first three cases, 0.5 mm for the last two) and volumetric MR imaging (1.5 T for the first three cases, 3 T for the last two). An interval of 24 hours was strictly observed between stages. Visual acuity and visual fields were assessed in all patients immediately prior to treatment and at intervals of 6 months thereafter. Follow-up MRIs were performed every 6 months for 2 years, then once per year.</p><p><strong>Results: </strong>The entire procedure, inclusive of imaging, treatment planning and treatment delivery, was performed in 5 days. Irradiation required approximately 45 min per stage. Mean tumor volume was 2.94 cc (range: 0.8-6.4 cc). Treatment was well tolerated in all patients. Follow-up ranged from 36 to 74 months. Local growth control was achieved in all patients. Restoration of normal vision was experienced by 4 patients 6 to 12 months after the treatment. One patient, who was also affected by diabetic retinopathy, showed a modest improvement after 6 months, remaining stable thereafter.</p><p><strong>Conclusion: </strong>Staged CyberKnife radiosurgery provides a fast and well-tolerated non-invasive treatment with excellent visual outcomes. If these preliminary results are confirmed by larger series, staged radiosurgery could be proposed as a first-line treatment for ONSM.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"16 6","pages":"257-66"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2011.622615","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30057929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Displays mounted on cutting blocks reduce the learning curve in navigated total knee arthroplasty.","authors":"Christoph Schnurr,&nbsp;Peer Eysel,&nbsp;Dietmar Pierre König","doi":"10.3109/10929088.2011.603750","DOIUrl":"https://doi.org/10.3109/10929088.2011.603750","url":null,"abstract":"<p><p>The use of computer navigation in total knee arthroplasty (TKA) improves the implant alignment but increases the operation time. Studies have shown that the operation time is further prolonged due to the surgeon's learning curve, and longer operation times have been associated with higher morbidity risks. It has been our hypothesis that an improvement in the human-machine interface might reduce the time required during the learning curve. Accordingly, we asked whether the use of navigation devices with a display fixed on the surgical instruments would reduce the operation time in navigated TKAs performed by navigation beginners. Thirty medical students were randomized and used two navigation devices in rotation: these were the Kolibri® device with an external display and the Dash® device with a display that was fixed on the cutting blocks. The time for adjustment of the tibial and femoral cutting blocks on knee models while using these devices was measured. A significant time reduction was demonstration when the Dash® device was used: The time reduction was 21% for the tibial block (p = 0.007), 40% for the femoral block (p < 0.001), and 32% for the whole procedure (p < 0.001). The integrated display, fixed on surgical instruments in a manner similar to a spirit level, seems to be more user-friendly for navigation beginners. Hence, unproductive time losses during the learning curve may be diminished.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"16 5","pages":"249-56"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2011.603750","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30062257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A method for identifying otological drill entanglement with a cotton swab.","authors":"Tianyang Cao,&nbsp;Xisheng Li,&nbsp;Zhiqiang Gao,&nbsp;Guodong Feng,&nbsp;Peng Shen","doi":"10.3109/10929088.2011.617834","DOIUrl":"https://doi.org/10.3109/10929088.2011.617834","url":null,"abstract":"<p><strong>Background: </strong>The entanglement of the otological drill with cotton swabs is a common milling fault in ear surgery. To improve operational safety, this paper presents a method for identifying this type of milling fault.</p><p><strong>Methods: </strong>Force and current sensors were installed on a modified otological drill. In accordance with the DC motor model and cutting force model, two features of the milling process were extracted, namely the characteristic curve and the dynamic relationship between the sensor signals. These are complementary features. An adaptive filter was designed to fuse them together and output a curve that was sensitive to milling faults and was stable during normal milling. Based on the filtering data, a rule base is presented for identifying cotton swab entanglement.</p><p><strong>Results: </strong>Five surgeons were invited to perform an experiment on calvarian bones. The average recognition rate for milling faults was 90%, whereas only 2% of normal millings were identified as milling faults.</p><p><strong>Conclusions: </strong>The presented method could adapt to the technique of different surgeons and identify milling faults exactly.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"16 6","pages":"267-79"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2011.617834","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30174347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer navigated total knee arthroplasty: aspects of a single unit's experience of 777 cases.","authors":"P Harvie,&nbsp;K Sloan,&nbsp;R J Beaver","doi":"10.3109/10929088.2011.586798","DOIUrl":"https://doi.org/10.3109/10929088.2011.586798","url":null,"abstract":"<p><p>The use of computer navigation and conventional techniques in total knee arthroplasty remains controversial. Advocates of computer navigated techniques cite better alignment of components and reduced morbidity associated with avoidance of intramedullary instrumentation as a rationale for their use. In contrast, proponents of conventional techniques argue that better alignment does not correlate with a better functional outcome and that the conventional approach avoids the perceived risk of fracture associated with bicortical insertion of navigation tracker pins. All total knee arthoplasties performed at our institution are prospectively monitored for life in a dedicated Joint Replacement Assessment Clinic (JRAC). Patients are reviewed by physiotherapists, independent of the surgeons who performed surgery, both preoperatively and at six weeks, three and six months, and one, two and five years postoperatively (and every five years thereafter). Patients are assessed using validated outcome measures (Knee Society Score, Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, Short Form SF-36 Health Survey (version 2) and a patient satisfaction score). In addition, at 6 months post surgery, a CT scan of each implanted prosthesis is performed using the Perth CT knee protocol. The findings of a single unit's experience of 777 navigated primary total knee replacements are discussed and critically compared to the body of literature that currently relates to this controversial topic.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"16 4","pages":"188-95"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2011.586798","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30240179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determination of the Whiteside line on femur surface models by fitting high-order polynomial functions to cross-section profiles of the intercondylar fossa.","authors":"Pietro Cerveri,&nbsp;Mario Marchente,&nbsp;Alfonso Manzotti,&nbsp;Norberto Confalonieri","doi":"10.3109/10929088.2011.555106","DOIUrl":"https://doi.org/10.3109/10929088.2011.555106","url":null,"abstract":"<p><p>Innovative methods for morphological and functional analysis of bones have become a primary objective in the development of planning systems for total knee replacement (TKR). These methods involve the interactive identification of clinical landmarks (reference points, distances, angles, and functional axes of movement) and the determination of the optimal implant size and positioning. Among the functional axes used to estimate the correct alignment of the femoral component, the Whiteside line, namely, the anterior-posterior (AP) direction, is one of the most common. In this paper, we present a computational framework that allows automatic identification of the Whiteside line. The approach is based on geometric analysis of the saddle shape of the intercondylar fossa to extract the principal line in the AP direction. A plane parallel to the frontal plane is moved in the AP direction to obtain the 2D profiles of the intercondylar fossa. Each profile is fitted to a fifth-order polynomial curve and its maximum curvature point computed. The point set collected across all the profiles is then processed to compute the principal direction. The 2D profile-fitting and 3D line-fitting residual errors were analyzed to study the relationship between the intercondylar fossa aspect and the nominal saddle surface. The method was validated using femur specimens from elderly subjects reconstructed from CT scans. The repeatability of the method was evaluated across five different femur surface resolutions. For comparison, three expert orthopaedic surgeons identified, by virtual palpation, the Whiteside line on the same 3D femur models. The repeatability (median angular error) of the Whiteside lines computed by the automated method and by manual virtual palpation, was approximately 1.0° and 3.5°, respectively. The angular skew error between the two axes, measured on the axial plane, averaged approximately 4.00° (SD: 2.64°) with no statistical difference. The automated method therefore proved more reproducible and was in agreement with the manual method. We conclude that operator-independent methods, such the one presented in this paper, can be favorably introduced into orthopaedic surgical planning systems.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"16 2","pages":"71-85"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2011.555106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29672992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-evaluation of the role of image guidance in minimally invasive pituitary surgery: benefits and outcomes.","authors":"Samip N Patel,&nbsp;A Samy Youssef,&nbsp;Fernando L Vale,&nbsp;Tapan A Padhya","doi":"10.3109/10929088.2011.552954","DOIUrl":"https://doi.org/10.3109/10929088.2011.552954","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the utility of performing endonasal transsphenoidal pituitary surgery with computer-based neuronavigation, and to examine the efficacy of computer-based neuronavigation compared to fluoroscopy.</p><p><strong>Patients: </strong>We conducted a retrospective review of patients who underwent pituitary surgery between September 1998 and September 2008. Of 120 consecutive patients, 70 met inclusion criteria and were fully examined. The inclusion criteria were that patients had undergone endonasal transsphenoidal pituitary surgery performed by the same neurosurgeon at the same institution. Nineteen of the patients were treated using intraoperative fluoroscopy and 48 were treated using the BrainLAB VectorVision neuronavigation system. Preparation times, surgical times and associated complications were analyzed.</p><p><strong>Results: </strong>Our results indicate that image guidance reduces the overall operating room time and complication rate. Average preparation time for fluoroscopy and computer-based neuronavigation was 70.3 and 67.3 min, respectively (p = 0.3299). Average surgical time with fluoroscopy and BrainLAB was 131 and 107.9 min, respectively (p = 0.0079). The results were also analyzed with regard to other parameters such as associated complications, age and diagnoses.</p><p><strong>Conclusion: </strong>Computer guided endoscopic endonasal transsphenoidal surgery provides a three-dimensional image to the surgeon, allowing for greater visual accuracy and surgical precision and a faster procedure without radiation exposure or the need for additional personnel.</p>","PeriodicalId":50644,"journal":{"name":"Computer Aided Surgery","volume":"16 2","pages":"47-53"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3109/10929088.2011.552954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29646486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}