Beller Siegfried, Eulenstein Sebastian, Lange Thomas, Hünerbein Michael, Schlag Peter M
Surgery and Surgical Oncology, Charitè Universitätsmedizin Berlin, Experimental and Clinical Research Center, Berlin, Germany.
J Hepatobiliary Pancreat Surg. 2009;16(2):165-70. doi: 10.1007/s00534-008-0040-z. Epub 2009 Jan 28.
INTRODUCTION: The main problems of navigation in liver surgery are organ movement and deformation. With a combination of direct optical and indirect electromagnetic tracking technology, visualisation and positional control of surgical instruments within three-dimensional ultrasound data and registration of organ movements can be realised simultaneously. METHODS: Surgical instruments for liver resection were localised with an infrared-based navigation system (Polaris). Movements of the organ itself were registered using an electromagnetic navigation system (Aurora). The combination of these two navigation techniques and a new surgical navigation procedure focussed on a circumscribed critical dissection area were applied for the first time in liver resections. RESULTS: This new technique was effectively implemented. The position of the surgical instrument was localised continuously. Repeated position control with observation of the navigation screen was not necessary. During surgical resection, a sonic warning signal was activated when the surgical instrument entered a "no touch" area--an area of reduced safety margin. CONCLUSION: Optical tracking of surgical instruments and simultaneous electromagnetic registration of organ position is feasible in liver resection.
引言:肝脏手术中导航的主要问题是器官的移动和变形。通过直接光学和间接电磁跟踪技术相结合,可以同时实现三维超声数据中手术器械的可视化和位置控制以及器官运动的配准。 方法:使用基于红外线的导航系统(北极星)对肝脏切除手术器械进行定位。使用电磁导航系统(奥罗拉)记录器官本身的运动。这两种导航技术与专注于划定关键解剖区域的新手术导航程序相结合,首次应用于肝脏切除手术。 结果:这项新技术得到有效实施。手术器械的位置被持续定位。无需通过观察导航屏幕进行重复的位置控制。在手术切除过程中,当手术器械进入“无接触”区域(安全 margin 降低的区域)时,会激活声音警告信号。 结论:手术器械的光学跟踪以及器官位置的同步电磁记录在肝脏切除手术中是可行的。
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