Visualisation and Navigation in Trauma & Orthopedic Surgery Flashcards
Why Navigation / Robots?
combine preoperative data to operation room
objectives of Image-based Intraoperativ Navigations Systems
Therapeutic Object (Patient)
Virtual Object (CT data,…)
Navigation System
classification of Image-based Intraoperativ Navigations Systems
Passive Systems
Semiactive Systems
Active Systems
aims of Image-based Intraoperativ Navigations Systems
Improvement of accuracy (ONLY THIS IS ACHIEVED IN PRACTICE)
Reduction of operation trauma
Reduction of operation time
Reduction of complications during operation
Improvement of long-term results (WE HAVE TO WAIT)
Problems of Image-based Intraoperativ Navigations Systems
Sterility
Human – Machine Interaction
Eye – Hand Coordination
most common navigation systems
C-Arm based Navigation
C-Arm and CT/MRI based
the most important tool for intraoperative visualization:
mobile C-arm
Why a mobile C-arm is preferred?
to find a target
to control
method or steps of navigation system with calibrated C-Arm
- step
- reference system - step
- 2 fluoro frames from
different angles - step
- planning two circles
advantages of CT over C-arm
better image quality
lower dose of radiation
(disadvantage: registration needed)
is sonography feasible for navigation? Why
No.
Ultrasound image is not easy to segment
problems of MRI based Navigation
- Segmentation
- Matching
- Modality based distortion (higher tesla produces more distortion)
why it is difficult to segment mri data
tissue intensities, non-uniformity (bias), noise artifacts, and partial volume effect
Pros of visualization and navigation
Visualization
* multiplanar
* flexible directions of view (e.g. operative view)
* Improved clarity (e.g. after colorful segmentation of a tumor including vessels/nervs)
Data Fusion
* information increase due to multimodal
imaging
* integration of functional findings
(statements)
Virtual 3D Modeling
- optimal spatial representation
- biomechanical evaluation
- optimized 3D planning
- check of contact, osteosysthesis
planning etc. …
Planning
- preop feasibility check
- virtual positioning of the implant
- optimized choose of implant
Accuracy
- exact intraoperative realization
- reproducibility (scientific studies)
- complication reduction
- biomech. optimization of implantat position
- influence on long-term results?!
Minimal Invasive
- small incisions
- transdermal methods
- minimal WT-mobilization
- minimal wound surface
- complication reduction
Documentation
- Preoperative planning documents
- intra- & postoperative documents (e.g.
screen shots of operation steps)
- quality management
Radiation Reduction
- for OR staff
- for patients
Tool for Education
- improved training through virtual
simulations (e.g. pedicular srew
postitioning, planning, in vitro OR etc.)
- extended intraoperative examination
Future pros of visualization and navigation
- biomechanical modeling
- collision animation
- telemedicine
