gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

Validating the navigated-controlled shaver in Functional Endoscopic Sinus Surgery (FESS)

Meeting Abstract

  • corresponding author Mathias Hofer - BMBF-Innovation Center Computer Assisted Surgery (ICCAS), Leipzig
  • Gero Strauss - Klinik und Poliklinik für HNO-Heilkunde/Plastische Operationen, Universitätsklinikum Leipzig
  • Andreas Pankau - BMBF-Innovation Center Computer Assisted Surgery (ICCAS), Leipzig
  • Andreas Dietz - Klinik und Poliklinik für HNO-Heilkunde/Plastische Operationen, Universitätsklinikum Leipzig
  • Mario Strauss - Berliner Zentrum für Mechatronik, Fraunhofer Institut IPK und Charité Berlin, Berlin
  • Sebastian Stopp - Berliner Zentrum für Mechatronik, Fraunhofer Institut IPK und Charité Berlin, Berlin
  • Kirill Koulechov - Berliner Zentrum für Mechatronik, Fraunhofer Institut IPK und Charité Berlin, Berlin
  • Tim Lüth - Berliner Zentrum für Mechatronik, Fraunhofer Institut IPK und Charité Berlin, Berlin

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno107

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno223.shtml

Published: September 22, 2005

© 2005 Hofer et al.
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Outline

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Purpose: In FESS one can find routine 3D-CT acquisition and navigation on one side and manual preparation through the surgeon on the other side. We saw a chance closing the gap. For that we applied a power supplied instrument (e.g. the shaver) to a navigation system. The instrument’s power supply is controlled as usual by a foot pedal through the surgeon. It is additionally controlled, for the instrument is only powered while the shaver tip is located within a preoperatively determined volume, the system is called FESS-control.

Methods: The system consists of an optical navigation system, a mouthpiece registration and the controlled shaver. Using navigation, we investigated the surgical accuracy touching stick-on fiducials on a plastic head with the shaver tip. The second part of the study investigated how true a planned volume was implemented. That was realized with a technical model, simulating a volume like the ethmoid cells and simulating anatomical conditions. Technical changes were made in comparison to our initial study from 2004.

Results: The maximum target positioning error proofed to be less than 1,33mm. Comparing the planned cavity versus the implemented cavity we received values of less than 1,8mm of maximum deviation. We received better results than in our initial study.

Conclusion: Surgical accuracy on landmarks was satisfactory. Using FESS-control, a planned cavity could be implemented well. Operating time of the navigation system was improved. In our clinic FESS is a frequent intervention. Changing the technical setup for FESS-Control in the operation room would be minimal, for the fundamental systems are already integrated.