Christoph Rathgeb1, Lukas Anschuetz2, Daniel Schneider1, Cilgia Dür3, Marco Caversaccio3, Stefan Weber1, Tom Williamson1. 1. ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland. 2. Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland. anschuetz.lukas@gmail.com. 3. Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, University Hospital and University of Bern, Bern, Switzerland.
Abstract
OBJECTIVE: We aimed to design, build and validate a surgical navigation system which fulfills the accuracy requirements for surgical procedures on the ear and the lateral skull base, and which integrates with the endoscopic workflow and operating room setup. MATERIALS AND METHODS: The navigation system consists of portable tablet computer (iPad Pro, Apple Computer, USA) and an optical tracking system (Cambar B1, Axios3D, Germany), both connected via a wireless Bluetooth link and attached directly to the OR table. Active optical tracking references are rigidly fixed to both the patient and surgical tools. Software to support image import, registration and 2D/3D visualization has been developed. Two models were used for targeting accuracy assessment: a technical phantom model and an ex vivo temporal bone model. Additionally, workflow integration and usability of the navigation system during endoscopic lateral skull base procedures was investigated in ex vivo experiments on 12 sides of cadaver head specimens. RESULTS: The accuracy experiments revealed a target registration error in the technical phantom model of 0.20 ± 0.10 mm (n = 36) and during the ex vivo assessment of 0.28 ± 0.10 mm (n = 21). Navigation was successfully carried out in n = 36 procedures (infracochlear, suprageniculate and transpromontorial approach), with navigated instruments usable without interference with the endoscope. The system aided in the successful and accurate identification of vital anatomical structures. CONCLUSIONS: Useful surgical navigation is, to a large extent, a result of sufficiently accurate tracking technology. We have demonstrated sufficient accuracy and a potentially suitable integration for surgical application within endoscopic lateral skull base procedures.
OBJECTIVE: We aimed to design, build and validate a surgical navigation system which fulfills the accuracy requirements for surgical procedures on the ear and the lateral skull base, and which integrates with the endoscopic workflow and operating room setup. MATERIALS AND METHODS: The navigation system consists of portable tablet computer (iPad Pro, Apple Computer, USA) and an optical tracking system (Cambar B1, Axios3D, Germany), both connected via a wireless Bluetooth link and attached directly to the OR table. Active optical tracking references are rigidly fixed to both the patient and surgical tools. Software to support image import, registration and 2D/3D visualization has been developed. Two models were used for targeting accuracy assessment: a technical phantom model and an ex vivo temporal bone model. Additionally, workflow integration and usability of the navigation system during endoscopic lateral skull base procedures was investigated in ex vivo experiments on 12 sides of cadaver head specimens. RESULTS: The accuracy experiments revealed a target registration error in the technical phantom model of 0.20 ± 0.10 mm (n = 36) and during the ex vivo assessment of 0.28 ± 0.10 mm (n = 21). Navigation was successfully carried out in n = 36 procedures (infracochlear, suprageniculate and transpromontorial approach), with navigated instruments usable without interference with the endoscope. The system aided in the successful and accurate identification of vital anatomical structures. CONCLUSIONS: Useful surgical navigation is, to a large extent, a result of sufficiently accurate tracking technology. We have demonstrated sufficient accuracy and a potentially suitable integration for surgical application within endoscopic lateral skull base procedures.
Authors: Nicolas Gerber; Brett Bell; Kate Gavaghan; Christian Weisstanner; Marco Caversaccio; Stefan Weber Journal: Int J Comput Assist Radiol Surg Date: 2013-06-14 Impact factor: 2.924
Authors: Tom Williamson; Kate Gavaghan; Nicolas Gerber; Stefan Weder; Lukas Anschuetz; Franca Wagner; Christian Weisstanner; Georgios Mantokoudis; Marco Caversaccio; Stefan Weber Journal: Otol Neurotol Date: 2017-06 Impact factor: 2.311
Authors: Marco Caversaccio; Kate Gavaghan; Wilhelm Wimmer; Tom Williamson; Juan Ansò; Georgios Mantokoudis; Nicolas Gerber; Christoph Rathgeb; Arne Feldmann; Franca Wagner; Olivier Scheidegger; Martin Kompis; Christian Weisstanner; Masoud Zoka-Assadi; Kai Roesler; Lukas Anschuetz; Markus Huth; Stefan Weber Journal: Acta Otolaryngol Date: 2017-02-01 Impact factor: 1.494
Authors: A E Rajesh; J T Rubinstein; M Ferreira; A P Patel; R A Bly; G D Kohlberg Journal: Int J Comput Assist Radiol Surg Date: 2022-01-28 Impact factor: 2.924
Authors: Daniel Schneider; Jan Hermann; Fabian Mueller; Gabriela O'Toole Bom Braga; Lukas Anschuetz; Marco Caversaccio; Lutz Nolte; Stefan Weber; Thomas Klenzner Journal: Front Surg Date: 2021-01-11