Computers are being prepped for the operating room as a tool to enhance the field of vision for surgeons using endoscopes to prowl around inside patients.
In a technique called image-guided surgery, the location of the endoscopic tip appears as a moving crosshair on digitized images of the targeted area as the endoscope is threaded through the surgical site.
Computer software sizes up the actual patient and lines up the surgicalTechnology
area with previously taken diagnostic images on a computer screen. Then sophisticated tracking technology plots the precise movement of the surgical tool on those images during the course of surgery, said Maurice Ferre, M.D., president of Visualization Technology.
The technology, which was exhibited at last week's Radiological Society of North America convention in Chicago, opens up the constricted view that surgeons now have of surgical areas through the endoscope.
It gives them a broader idea of where the instrument is, what's around it, and how close it is to vital organs and arteries, said Ferre, whose Boston-based startup company is testing such a system for sinus surgery.
The company is applying research under way at the surgical planning laboratory of Brigham and Women's Hospital, which is trying to improve results of minimally invasive surgery.
By guiding surgical instruments and tiny video cameras through punctures or existing body cavities, surgeons can cut the recovery time and the hospitalization of their patients.
But the work is slow going and cautious because of the narrow field of vision offered by the video picture, said Ron Kikinis, M.D., director of Brigham and Women's laboratory. With image-guided surgery, "we can provide the surgeons with road maps so they're more effective in surgery," he said.
Until now, surgeons had to look at diagnostic images and make a "mental transfer" of the images to the surgical area, Ferre said. The new technique puts the images in front of the surgeon and shows, for example, how close the endoscope is to the brain, optic nerve or nearby carotid arteries during delicate sinus surgery, he said.
In 100 procedures performed by 15 surgeons at Boston teaching hospitals, the extra guidance helped shorten surgery time by 30%, Ferre said. The technology could build more operating-room volume while reducing complications, he said.
About 300,000 sinus procedures are done annually, he said, and the surgery often involves repeat procedures because physicians haven't been comfortable enough with their view of the area to clean out air passages completely the first time. Image-guided surgery could reduce the number of repeat surgeries for hospitals operating under managed-care contracts, he said.
Visual Technology expects to file this month for required Food and Drug Administration approval to market the technology as a medical device. Ferre said the package, including a powerful computer, the software and the tracking tip, would be priced at about $90,000.
The tracking component is adapted from the technology used to track missiles during the Persian Gulf War, Ferre said. The computer is manufactured by Sun Microsystems Computer Corp.