Purchase this article with an account.
Louise A. Mawn, Martha I. Conley, Nkiruka Atuegwu, Robert Galloway; Assessment of Intraorbital Endoscopic Image Guidance System in Human Phantoms. Invest. Ophthalmol. Vis. Sci. 2011;52(14):715.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To overcome the challenge of access to the optic nerve, we developed a minimally-invasive, image guided surgery (IGS) system based upon tracking via deformation of a magnetic field. In this study we compare performance of image guided endoscopy to non-image guided endoscopy in a surgical model of orbital endoscopy.
In previous work we developed a combined image-guided orbital endoscopic system for the delivery of therapy to the optic nerve. Human phantoms with one radio-opaque target and three distracter colored targets secured within the orbits were created. Twenty-eight surgeons then used the system in paired trials of image guided compared to non-image guided surgery.
Real time image guidance and endoscopic video information was demonstrated during these trials. Across all trials the time decreased, demonstrating a learning curve of using the orbital endoscope. There was a marginally significant increase in time using the image guidance, 97 seconds versus 62.5 seconds (p=0.056); but, particularly in the less experienced surgeons, the guidance system reduced the error rate.
IGS has not had the impact on eye disease that it has had on other surgical fields. The learning curve of using an orbital endoscope was demonstrated during our trials. Surgeons became more facile with the technology over as few as 4 trials. IGS may have greater importance for less experienced surgeons and in patients with more disrupted anatomy to allow for better target localization through better update of surgical position. Surgical phantoms will likely become an important surgical teaching tool in Ophthalmology as it has been for learning endoscopy skills in other surgical disciplines.
This PDF is available to Subscribers Only