Article
Validating the navigated-controlled shaver in Functional Endoscopic Sinus Surgery (FESS)
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Published: | September 22, 2005 |
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Purpose: In FESS one can find routine 3D-CT acquisition and navigation on one side and manual preparation through the surgeon on the other side. We saw a chance closing the gap. For that we applied a power supplied instrument (e.g. the shaver) to a navigation system. The instrument’s power supply is controlled as usual by a foot pedal through the surgeon. It is additionally controlled, for the instrument is only powered while the shaver tip is located within a preoperatively determined volume, the system is called FESS-control.
Methods: The system consists of an optical navigation system, a mouthpiece registration and the controlled shaver. Using navigation, we investigated the surgical accuracy touching stick-on fiducials on a plastic head with the shaver tip. The second part of the study investigated how true a planned volume was implemented. That was realized with a technical model, simulating a volume like the ethmoid cells and simulating anatomical conditions. Technical changes were made in comparison to our initial study from 2004.
Results: The maximum target positioning error proofed to be less than 1,33mm. Comparing the planned cavity versus the implemented cavity we received values of less than 1,8mm of maximum deviation. We received better results than in our initial study.
Conclusion: Surgical accuracy on landmarks was satisfactory. Using FESS-control, a planned cavity could be implemented well. Operating time of the navigation system was improved. In our clinic FESS is a frequent intervention. Changing the technical setup for FESS-Control in the operation room would be minimal, for the fundamental systems are already integrated.