Surgical navigation systems: Safely guiding the scalpel

Imaging, navigation, integration – these are terms that describe the modern operating room. All of these components play a key role in accurate surgical procedures. They are integrated into surgical navigation systems, which make complicated medical surgeries considerably safer.

Surgical navigation systems are an integral part of computer-assisted surgery (CAS). This represents a concept that supports surgical procedures based on digital imaging technology. It affords surgeons the opportunity to pre-operative planning and accurate surgical navigation of instruments during the procedure.

Computer-assisted surgery was developed in the mid-eighties. While the procedure originates from task forces in neurosurgery and ENT surgery, there is a wide variety of application fields today. Surgical navigation systems also assist in oral and maxillofacial surgery, orthopedic surgery, visceral radiosurgery as well as implant dentistry.

In the future, surgical navigation systems will be increasingly augmented and assisted by computers. By integrating all of the components in the operating room, the ICCAS (Innovation Center Computer Assisted Surgery) wants to make the "Operating Room of the Future" a reality as part of the nationwide German OR.NET joint research project.

"The physician should receive all the necessary information when he/she makes complex treatment decisions during a surgical intervention," says Professor Andreas Melzer, Executive Director of the ICCAS. "The idea is to avoid errors, increase patient safety and relieve the surgeon because the system is designed to work in synch with him/her. I think the OR of the future will be shaped by the interaction between medical devices."

Computer-assisted surgery makes minimally invasive surgical solutions possible. The surgeon quickly gets information to determine where he/she needs to make incisions and perform surgery. Not only does this mean a gentler treatment and less pain for patients, it also leads to more precision, a shorter surgical procedure, and thus lower costs.

Despite the distinct advantages and possibilities, surgical navigation systems also have some drawbacks. For example, they only offer a limited number of programmed surgical interventions. They reach their limits when it comes to more complex surgeries. The systems still require further development at this juncture.

The medical technology field is known for its continuous advances. That's why we have a wide range of technologies designed to support today’s surgical navigation. In addition to systems that work with conventional imaging techniques such as CT scans or MRI, manufacturers also develop surgical instruments that can be integrated into the systems via sensors.

The navigation systems for ENT, spine or cranial surgery made by the Fiagon GmbH create a three-dimensional chart of the body’s interior based on computed tomography data acquisition. Attached to the tip of the respective surgical instrument are microsensors that indicate the exact position and orientation inside the patient. This permits the high-precision navigation of the thin, flexible instruments during the surgical procedure.

The Scopis GmbH is developing –among other things- the Holographic Navigation Platform, which can be supported by using augmented reality. This allows the surgeon to see more than just the image of his/her endoscope on the monitor. The surgeon also obtains additional information about the remaining distance to the tumor for example.

Products made by Brainlab are also featured in surgical practice. The medical technology company specializes in developing software for the various stages and phases of the surgical procedure. The broad range of products includes planning software, software and systems for surgical navigation and intraoperative imaging, data management and data processing applications.

Surgical planning, precision, patient safety – surgical navigation systems have countless benefits. Having said that, we still have a long way to go before the fully integrated "Operating Room of the Future" becomes a reality. "The final step as it relates to the optimal surgical suite design to assist surgeons will still take some time," Professor Melzer points out. There is also a lack of selection as it pertains to navigation software “but the necessary components are already available.“