Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
Issue link: http://outpatientsurgery.uberflip.com/i/122240
OSM560-April_DIGITAL_Layout 1 4/5/13 2:29 PM Page 71 ASSESSING YOUR OPTIONS Which Image-Guided ENT System Is Right for You? Brent A. Senior, MD E NT navigation comes in 2 forms: electromagnetic or infrared (optical). At my teaching hospital, I have the advantage of using each option. Both are great and have particular benefits — it's just a matter of finding the system that matches your surgeons' preferences and the types of cases you host. • Electromagnetic guidance. Surgeons don't need to maintain a direct line of sight between instruments and the image processor. They typically FAMILIAR FEEL Infrared sensors let must use proprietary instruments, how- surgeons track the ever, and the surgical team must keep instruments they're accustomed to metal items away from the patient in using. order to avoid interfering with the system's electromagnetic field. Surgeons who use electromagnetic systems don't have to worry about blocking the system's image transmission, meaning they can position their hands as they're accustomed to doing and set up their rooms however they choose. In most cases, however, they're restricted to whatever instruments — such as a suction and curette — the system's manufacturer provides. (Research is ongoing aimed at developing instrument adaptors for use with electromagnetic systems, so surgeons might be able to track their own instruments in the not-so-distant future.) The instruments are wired to the electromagnetic system, creating a potential tug on instruments that could inhibit surgeons' movements within the surgical cavity. Many of the companies that produce electromagnetic systems are constantly modifying their proprietary instruments with the aim of providing surgeons with more ergonomic and effective options. However, greater progress is needed on this front. Besides, most surgeons prefer to work with the tools they already feel comfortable using. Does that negate the many benefits of an electromagnetic system? No, but it's something to be aware of when you're deciding between the imageguided options. Electromagnetic systems may be best suited for complex cases, such as minimally invasive skull base surgery, when many surgical team members and additional docs (often neurosurgeons) crowd around the table. Using an electromagnetic system in this situation eliminates worries about line-of-sight issues and hand position- A P R I L 2 013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E | 7 1