Strauss G, Schaller S, Zaminer B, Heininger S, Hofer M, Manzey D, Meixensberger J, Dietz A, Lüth T C
Klinik und Poliklinik für HNO-Heilkunde/Plastische Operationen, Universität Leipzig, Liebigstrasse 10-14, 04103, Leipzig, Deutschland.
HNO. 2011 May;59(5):470-9. doi: 10.1007/s00106-010-2237-0.
The goal of this work is the extension of instrument navigation with a collision warning function. With the help of an additional distance display and warning system the performance of surgical navigation systems should be improved.
The collision warning system (DCS) is an extension of an optoelectric navigation system (NPU, Karl Storz GmbH&Co.KG, Tuttlingen, Germany). The measurement of situation awareness was performed on phantom models of functional endoscopic surgery of the paranasal sinuses (FESS; Phacon, Leipzig). Altogether 450 measurement pairs for the analysis of surgical accuracy to the risk structure (frontal skull base, lamina papyracea, internal carotid artery) were available. To examine the influence on the clinical process, a prospective analysis of intraoperative complications was carried out. Of the 104 FESS patients, two groups, one of 56 patients with only navigation (NAV) and one of 48 patients (NAV+DCS), were examined. Efficiency was evaluated on the basis of times for system preparation and intraoperative application.
A significant increase in the assumed and actual distance values between instrument tip and risk structure using the collision warning system was seen at 76%. The complication rate was more favorable for the NAV+DCS group. The time needed for preparation of the navigation system with the application of the collision warning system increased on average by 48%, or 1.2 min. However, the relation between preparation time and utilization time was approximately the same at 53.5% in the NAV group and 57.4% in the NAV+DCS group.
This work supports the clinical use and efficiency of a collision warning system as an addition to well-known instrument navigation in endo- and transnasal surgery. The segmenting algorithm is suitable for clinical requirements.
这项工作的目标是扩展具有碰撞预警功能的器械导航。借助额外的距离显示和预警系统，应提高手术导航系统的性能。
碰撞预警系统（DCS）是对光电导航系统（NPU，卡尔·史托斯有限公司，德国图特林根）的扩展。在鼻窦功能性内窥镜手术（FESS；Phacon，莱比锡）的模型上进行态势感知测量。总共获得了450对测量数据，用于分析手术对风险结构（额颅底、纸样板、颈内动脉）的准确性。为了研究对临床过程的影响，对术中并发症进行了前瞻性分析。在104例FESS患者中，分为两组，一组56例仅使用导航（NAV），另一组48例（NAV+DCS）进行检查。根据系统准备和术中应用的时间评估效率。
使用碰撞预警系统时，器械尖端与风险结构之间的假定距离值和实际距离值显著增加，比例为76%。NAV+DCS组的并发症发生率更有利。应用碰撞预警系统时，导航系统的准备时间平均增加了48%，即1.2分钟。然而，准备时间与使用时间的关系在NAV组约为53.5%，在NAV+DCS组约为57.4%，大致相同。
这项工作支持将碰撞预警系统作为鼻内和经鼻手术中知名器械导航的补充用于临床，其分割算法适合临床需求。
