Unité de recherche clinique Lariboisière-Saint Louis, hôpital Fernand-Widal, Assistance Publique Hôpitaux de Paris, Université Paris 7, 200, rue du Faubourg Saint Denis, 75010 Paris, France.
Clinique de l'Atlantique, 26, rue du Moulin des Justices, 17138 Puilboreau, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Nov;136(6):461-464. doi: 10.1016/j.anorl.2019.08.002. Epub 2019 Aug 29.
Surgical navigation systems (SNS) are now widely used in endoscopic endonasal surgery. Benefit, however, has not been fully studied. The objective of this study was to evaluate the impact of an SNS in terms of performance of the surgical procedure and of surgeon satisfaction, in a prospective multicenter study.
A multicenter prospective study included patients undergoing endoscopic endonasal surgery using the electromagnetic DigiPointeur® (DGP) SNS in 16 French hospitals. An observation form, completed by the surgeon immediately at end of procedure, included type of procedure, and any changes in strategy or extent of surgery related to use of the SNS. Surgeon satisfaction was rated on an analog scale, with self-assessment of stress experienced during the procedure.
The study included 311 patients operated on by 36 surgeons in 16 French hospitals. Ethmoidectomy was the most frequent procedure (90%); tumor resection was performed in 5.1% of cases. The SNS enabled more extensive surgery in 81% of cases, in particular by identifying and opening additional cells (57% of cases). Mean satisfaction was 8.6/10; surgeons reported decreased surgical stress thanks to the SNS in 95% of cases.
In this observational study, the use of an SNS increased the extent of surgery in 81% of cases, and had a positive impact on the stress perceived by the surgeon in 95% of cases.
手术导航系统（SNS）现已广泛应用于鼻内镜手术。然而，其益处尚未得到充分研究。本研究旨在通过前瞻性多中心研究评估 SNS 在手术操作表现和外科医生满意度方面的影响。
这项多中心前瞻性研究纳入了在 16 家法国医院使用电磁 DigiPointeur®（DGP）SNS 进行鼻内镜手术的患者。由外科医生在手术结束时立即填写观察表，内容包括手术类型，以及与 SNS 使用相关的手术策略或范围的任何变化。使用模拟量表评估外科医生的满意度，并评估手术过程中的压力。
该研究纳入了 311 名在 16 家法国医院由 36 名外科医生进行手术的患者。筛窦切除术是最常见的手术（90%）；肿瘤切除术占 5.1%。SNS 使 81%的情况下手术范围更广泛，特别是通过识别和打开额外的细胞（57%的情况下）。平均满意度为 8.6/10；95%的情况下，外科医生报告由于 SNS 的使用，手术压力有所减轻。
在这项观察性研究中，SNS 的使用使 81%的情况下手术范围更广泛，并对 95%的情况下外科医生感知的压力产生积极影响。
