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Working off fused images gives surgeons detailed information about
all layers of the anatomy they're working in and around. It's an inter-
esting imaging modality, but might be more applicable in brain sur-
gery, when you're operating in different sub-area compartments of the
brain. In my view, it doesn't offer the same benefit during routine
sinus surgery.
What's next?
The original generation of proprietary instruments used with electro-
magnetic systems were variations of the powered rotary instruments
used in orthopedics. They've been adapted further, but are still fairly
cumbersome. Suction devices are relatively comfortable to use, but
some instruments that cut and seal to remove polyps and tumors in a
relatively bloodless field need to be designed with ergonomics in
mind. There's certainly a limit to how small and flexible powered
instruments can be made, but this is an area of needed improvement.
Will image-guided instruments someday be able to guide surgeons
along a pre-programmed surgical path? Perhaps, but there's an interim
step that needs to be taken first. The technology's next advancement
should involve capturing real-time images in the OR.
Images of patients' anatomy taken during pre-op CT scans and pro-
grammed into the image-guided systems provide extremely accurate
snapshots of a patient's unique nasal and skull base anatomy. But after
surgeons remove the targeted pathology, the images on the screen are
suddenly inaccurate. Surgeons still see the exact location of critical
structures, but can't tell for certain if they've completely removed the
pathology they set out to excise.
Patients often undergo post-op CT scans or MRIs the afternoon or
morning after surgery to confirm the removal of pathology. If surgeons
could determine a procedure's outcome while the patient was still
S I N U S S U R G E R Y
