Evaluation of an image-guided navigation system in the training of functional endoscopic sinus surgeons. A prospective, randomised clinical study

Stelter, Klaus; Ertl‐Wagner, Birgit; Luz, María; Müller, Sigrid; Ledderose, Georg; Siedek, Vanessa; Berghaus, A; Arpe, S; Leunig, Andreas

doi:10.4193/rhin11.035

Cited by 24 publications

(28 citation statements)

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“…Only one prospective, randomized, cohort study has been published on this topic. 9 The authors documented infrequent minor complications, which were distributed equally between IGS and non-IGS sides in a series of 32 patients operated on by trainee surgeons. Data from more experienced surgeons have been published with varying results but, in general, have not shown a significant decrease in complications.…”

Section: Reported Impact On Complicationsmentioning

confidence: 99%

“…In fact, one published study reported trainees using IGS seemed to trust the navigation system more than 90% of the time and demonstrated a significantly increased willingness to take risks when using the navigation system. 9 When is IGS used? Expert opinion and clinical experience suggest that it is not necessary to use IGS in a routine fashion, but rather to consider its use in cases outlined by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) published guidelines (Box 1).…”

Section: Current Technology and Usementioning

confidence: 99%

“…There should be little debate that IGS in such scenarios improves the surgeon's sense of spatial orientation and situational awareness. 9,13 One manner of improving spatial orientation and anatomic understanding is the ability to scroll through images in 3 planes in real time. This is perhaps one of the most valuable aspects of this technology.…”

Section: Current Technology and Usementioning

confidence: 99%

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Does Image-Guided Surgery Reduce Complications?

Ramakrishnan

Kingdom

2015

Otolaryngologic Clinics of North America

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Section: Reported Impact On Complicationsmentioning

confidence: 99%

Section: Current Technology and Usementioning

confidence: 99%

Section: Current Technology and Usementioning

confidence: 99%

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Does Image-Guided Surgery Reduce Complications?

Ramakrishnan

Kingdom

2015

Otolaryngologic Clinics of North America

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“…Auch der operative Eingriff selbst verlängert sich bei ungeübten Operateuren jeweils um ca. 16 min [ 570 ] . Bei technischen Unzulänglichkeiten ist der Zeitverlust deutlich höher; zusätzlich müsste Arbeitszeit für die Aufbereitung des Datensatzes kalkuliert werden [ 572 ] .…”

Section: Ballon-dilatationunclassified

“…Die Vollständigkeit des Eingriff es nimmt subjektiv und objektiv zu [ 570 , 577 ] . Unerfahrene überschätzen auf der anderen Seite den Nutzen der Systeme -in der Folge wird ein Abhängigkeits-verhältnis und ein negativer Eff ekt bei der individuellen Ausarbeitung persönlicher Handlungs-Algorithmen zur intraoperativen Problemlösung befürchtet ("surgical skill loss") [ 570 ] . Aus diesem Grunde wird eine generelle Anwendung von mancher Seite nicht empfohlen [ 568 ] .…”

Section: Ballon-dilatationunclassified

Fehler und Gefahren: Eingriffe an den Nasennebenhöhlen und der Frontobasis unter Berücksichtigung mediko-legaler Aspekte

Hosemann

2013

Laryngo-Rhino-Otol

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Endoscopic endonasal sinus surgery represents the overall accepted type of surgical treatment for chronic rhinosinusitis. Notwithstanding raised and still evolving quality standards, surgeons performing routine endoscopic interventions are faced with minor complications in 5% and major complications in 0.5-1%.A comprehensive review on all minor and major complications of endoscopic surgery of the paranasal sinuses and also on the anterior skull base is presented listing the actual scientific literature. The pathogenesis, signs and symptoms of each complication are reviewed and therapeutic regimens are discussed in detail relating to actual publication references. Potential medico-legal aspects are explicated and recent algorithms of avoidance are mentioned taking into account options in surgical training and education.

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The Utility of Image Guidance in Endoscopic Sinus Surgery

Beswick¹,

Ramakrishnan²

2020

JAMA Otolaryngol Head Neck Surg

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IMPORTANCE More than a quarter-million cases of endoscopic sinus surgery (ESS) are performed annually in the United States. Most surgeons use image-guided systems as an adjunct during surgery in certain situations. Understanding the association of image-guided surgery (IGS) with surgical outcomes, complications, and surgeon factors is paramount.OBSERVATIONS Three systematic or evidenced-based review articles demonstrated no clear evidence that IGS improves surgical outcomes for chronic rhinosinusitis, including completeness of surgical dissection, patient-reported outcomes, or rates of revision surgery. Results from 2 systematic reviews suggest that major and total surgical complications may be decreased with use of IGS in certain cases, although bias may confound these findings. When complications were analyzed individually, there was no definitive evidence that IGS is associated with decreased rates of orbital, intracranial, or hemorrhagic complications. The rarity of complications in ESS, developing surgical experience, evolving training strategies, and selective use of IGS in more complex cases make future study on the association of IGS with complications challenging. Limited data on the influence of IGS on surgeon satisfaction and stress level suggests that more experienced surgeons might glean benefits in these realms, whereas junior surgeons may feel additional stress when using the technology.CONCLUSIONS AND RELEVANCE Level 2A evidence from systematic reviews suggests that in certain cases IGS may be associated with decreased major and total surgical complications, though the potential for bias and confounding exists in these conclusions. It is possible that, among more experienced surgeons, the use of IGS is associated with improvements in stress and satisfaction, although evidence in this realm is limited and there may be additional stresses associated with IGS for surgeons early in their career. The choice to use IGS in any endoscopic procedure remains best determined by the operating surgeon based on factors including case complexity and surgeon comfort.

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Evaluation of an image-guided navigation system in the training of functional endoscopic sinus surgeons. A prospective, randomised clinical study

Cited by 24 publications

References 0 publications

Does Image-Guided Surgery Reduce Complications?

Does Image-Guided Surgery Reduce Complications?

Fehler und Gefahren: Eingriffe an den Nasennebenhöhlen und der Frontobasis unter Berücksichtigung mediko-legaler Aspekte

The Utility of Image Guidance in Endoscopic Sinus Surgery

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