He Bin, Xu Chao, Mao Yingdelong, Mao Jingwen, Shen Liping, Wei Hao, Wang Fei, Xu Shuogui
The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China.
HangZhou Santa Medical Technology Co., Ltd, Hangzhou, 310005, China.
Int J Comput Assist Radiol Surg. 2016 Nov;11(11):2105-2110. doi: 10.1007/s11548-016-1424-1. Epub 2016 May 27.
Metallic foreign bodies (MFBs) retained in soft tissue may pose potential threats to patient health. Interventional procedures using conventional navigation systems are associated with high rate of radiation exposure. We postulated that the surgical approach visualization and navigation system would offer precise percutaneous localization and linear guidance with reduced radiation dosage and system complexity.
In total, 76 patients underwent percutaneous MFB extraction with the technique, which consists of: (A) displaying the target spot (here the MFB) on the screen; (B) projecting the laser beam onto the skin surface; (C) indicating the optimal direction and angle of the needle; and (D) guiding the surgical approach until the MFB was extracted.
A total of 76 MFBs were successfully extracted with a single operation. No systemic complications were observed. The procedure took between 2 and 11 min, with an average of [Formula: see text] min, demonstrating the characteristics of a normal distribution. The mean size of wound was [Formula: see text] mm. The mean amount of bleeding was [Formula: see text] ml. The number of times the intra-operative fluoroscopy was used ranged from one to four times for a single procedure, with an average of 1.89 ± 0.74.
The proposed navigation system which combines the laser positioning and navigation techniques seems to be a novel surgical approach of high accuracy and efficiency.
软组织中留存的金属异物(MFBs)可能对患者健康构成潜在威胁。使用传统导航系统的介入手术会带来较高的辐射暴露率。我们推测,手术入路可视化和导航系统将能提供精确的经皮定位和线性引导,同时降低辐射剂量和系统复杂性。
共有76例患者采用该技术进行了经皮MFB取出术,该技术包括:(A)在屏幕上显示目标点(此处为MFB);(B)将激光束投射到皮肤表面;(C)指示针的最佳方向和角度;(D)引导手术入路直至取出MFB。
单次手术成功取出76个MFB。未观察到全身并发症。手术时间为2至11分钟,平均为[公式:见原文]分钟,呈正态分布特征。伤口平均大小为[公式:见原文]毫米。平均出血量为[公式:见原文]毫升。单次手术术中使用荧光透视的次数为1至4次,平均为1.89±0.74次。
所提出的结合激光定位和导航技术的导航系统似乎是一种高精度、高效率的新型手术方法。