The presented system allows the planning and drilling of multiple minimally invasive canals at the lateral skull base. Further studies are required to reduce the drilling error and evaluate the clinical application of the system.
For multiport image-guided minimally invasive surgery at the lateral skull base a quality management is necessary to avoid the damage of closely spaced critical neurovascular structures. So far there is no standardized method applicable independently from the surgery. Therefore, we adapt a quality management method, the quality gates (QG), which is well established in, for example, the automotive industry and apply it to multiport image-guided minimally invasive surgery. QG divide a process into different sections. Passing between sections can only be achieved if previously defined requirements are fulfilled which secures the process chain. An interdisciplinary team of otosurgeons, computer scientists, and engineers has worked together to define the quality gates and the corresponding criteria that need to be fulfilled before passing each quality gate. In order to evaluate the defined QG and their criteria, the new surgery method was applied with a first prototype at a human skull cadaver model. We show that the QG method can ensure a safe multiport minimally invasive surgical process at the lateral skull base. Therewith, we present an approach towards the standardization of quality assurance of surgical processes.
Intraoperative C-Bogen-Fluoroskopie dient bei der bronchoskopischen Biopsie zur Lokalisation des Bronchoskops und der Biospiezange innerhalb des Patiententhorax. Bei bekannter C-Bogen Pose ist es möglich, aus der 2D-Position der Instrumentenspitze auf der Fluoroskopie deren 3D-Position innerhalb des Bronchialbaums zu berechnen. Während die Pose mit Hilfe einer Markerplatte auf dem Patiententisch bestimmt werden kann, fehlt bisher eine automatische Verfolgung der Instrumentenspitze auf der kontinuierlichen Fluoroskopie. In dieser Arbeit wird eine solche Tracking-Methode vorgestellt und evaluiert. Erste Experimente an einem Bronchialbaum-Phantom lieferten sehr robuste und präzise Ergebnisse und auch die Echtzeitfähigkeit konnte gezeigt werden
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