Outpatient Surgery Magazine

Special Outpatient Surgery Edition - Surgical Construction - March 2018

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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M A R C H 2 0 1 8 • O U T PA T I E N T S U R G E R Y. N E T • 5 3 Computer-guided systems work off of pre-op MRI and CT scans of the patient's sinus anatomy that are loaded into the image-guided computer system, which projects anatomical landmarks of a patient's sinus onto a monitor in the OR. As surgeons operate, they can track how far they're progressing along a pre-planned surgical pathway and know exactly where their instruments are located as they maneuver around delicate structures in the sinus cavity. Computer-guided systems come with 2 basic instrument options: • Electromagnetic guidance. Surgeons don't need to maintain a direct line of sight between instruments and the image processor. They typically must use proprietary instruments, however, and the surgical team must keep metal items away from the patient in order to avoid interfering with the system's electromagnetic field. • Infrared guidance. Passive systems have fiducial markers placed on the patient and instruments that reflect infrared light back to the system's camera. Active systems have infrared-emitting diodes on oper- ating instruments that are actively tracked by an overhanging camera. With both types of infrared technologies, surgeons must maintain a clear line of sight between the instruments and the imaging unit. "Electromagnetic instruments are more plug-and-play," says oto- laryngologist Brett Scotch, MD, FAOCO, of the Select Physicians Alliance, a Tampa, Fla.-based practice of ENT docs that opened the Select Physicians Surgery Center in 2016. That's an important consid- eration, he says, because surgeons and staff shouldn't have to worry if the way they set up equipment and instrument tables in the OR occludes the line of sight that needs to be maintained when you use infrared systems. The Select Physicians Surgery Center initially invested in 2 new computer-navigation units, which Dr. Scotch says are compact and easy to maneuver from room to room and a cinch to set up and break

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