Choosing a computer-assisted surgical system for sinus surgery.
OBJECTIVE
Choosing the correct computer-assisted system for sinus surgery can be a formidable task for surgeons and their institutions. A formal trial of an electromagnetic (InstaTrak, Visualization Technologies Incorporated, Woburn, MA) and an optical (LandmarX by Medtronic-Xomed, Jacksonville, FL) system was conducted over a 10-month period at the St. Paul's Sinus Centre in Vancouver, BC. An objective and subjective evaluation method was used to select the system for use at our institution.


METHODS
Thirty-nine patients were operated on by the senior author (A.R.J.) using the InstaTrak (23 patients) or the LandmarX (16 patients). The two groups were balanced in terms of age, gender, number of previous surgeries, and extent of surgery. Estimated blood loss, surgical time, and surgical complications were compared between the groups, with all other variables constant. Nursing and radiology personnel as well as the three surgeons who used both systems at the centre were surveyed on patient safety, ease of use, storage, and accessories.


RESULTS
There was no statistical difference in objective surgical data. There was a more pronounced learning curve using the LandmarX as defined by a greater decrease in the duration of surgical time by the end of the trial period. The operating room personnel found the InstaTrak easier to use, whereas the computed tomography technologists preferred the LandmarX. The surgeons found the two systems acceptable in terms of navigational accuracy; however, the InstaTrak was felt to be more user friendly.


CONCLUSIONS
The InstaTrak system was chosen for our institution mainly because of its ease of use by the operating room staff and the sinus surgeons.
Kherani
Safeena
S
Paul's Sinus Centre, ENT Clinic, St. Paul's Hospital, Vancouver, British Columbia.
Javer
Amin R
AR
Woodham
Jeremy D
JD
Stevens
Holly E
HE
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003258:Consumer Behavior; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed / Q000295:instrumentation*