Report of a New Passive, Optical Surgical Navigation System for Endoscopic Sinus Surgery Martin J. Citardi, M.D. Saint Louis University Department of Otolaryngology.

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Presentation transcript:

Report of a New Passive, Optical Surgical Navigation System for Endoscopic Sinus Surgery Martin J. Citardi, M.D. Saint Louis University Department of Otolaryngology

Computer-Aided Sinus Surgery Anatomic complexity Limitations of endoscopic visualization Surgical navigation systems

SAVANT New CAS platform Cbyon (Palo Alto, CA) Optical tracking system Windows NT platform Report of initial FDA trial

Methods Prospective trial (FDA protocol) 1 mm axial CT transferred to workstation via network Visual estimates of registration accuracy Surgeon’s questionnaires

SAVANT Pre-release software version ( ) Headset reference frame Semiautomatic registration Passive (wireless) instruments

Semiautomatic Registration Headset at time of CT scan and OR Registration to points on headset

SAVANT Instrumentation

Results 17 patients enrolled Indication: chronic rhinosinusitis Failure to achieve acceptable registration in 1 instance Surgery canceled in 1 instance (asthma exacerbation) 15 patients completed protocol

Results Registration accuracy estimates at 4 points in surgical volume Distribution of estimates: 0-2 mm.38 (63.3%) 2-4 mm.14 (23.3%) 4-6 mm.3 (5.0%) >6 mm.5 (8.3%)

Subjective Evaluation Relatively easy set-up, especially for a developmental system Good user interface Excellent monitor Excellent technical support

Representative Images

Headset Issues Modified Anatomark headset (designed for co- registration of MR/CT scans) DRF design Ear piece calibration Fully automatic registration anticipated

Advantages Even semiautomatic registration rapid Passive (wireless) tracking Excellent user interface Automatic registration in development

Disadvantages Headset design issues Semiautomatic registration Note: Technical solutions are on the horizon…

Summary Preliminary report of a new CAS system for sinus surgery Promising technological platform System limitations identified; technical solutions in early implementation phase Additional reports forthcoming…