[Information assisted surgery as a transdisciplinary surgical procedure].
BACKGROUND
Information assisted surgery (IAS) is a further development of the computer assisted surgery (CAS) exclusively for intraoperative localization serving as basis for future technologies such as mechatronic and robotic. It requires of the surgeon a turnaround from traditional surgical proviso as well as transdisciplinary knowledge in the areas of surgical medicine, radiological imaging and information. The advantage of IAS is the predictability of the surgical procedure according to the specifications of modern quality assessment.


METHODS
We analyzed the possibilities for the application of IAS in interdisciplinary transfacial surgery of the frontobasis in 9 patients with different pathologies of the central skull base and the cranio-cervical junction and compared this to conventional CAS.


RESULTS
We determined retrospectively with a quality assessment analysis that surgery planning is too time consuming in the moment, and that the necessary transdisciplinary knowledge for IAS cannot be taken for granted yet. IAS has not been consequently applied for the entire surgery process in any of the 9 cases. This was due to technical difficulties as well as large intraoperative accuracy deviations of more than 5 mm.


CONCLUSIONS
Even though the highly-developed technology of IIAS -- intelligent information assisted surgery -- is available, with the possibility of half or fully automatic implementation of IIAS including a automatic re-referencing, this technology will not be used in medical navigation for strategic reasons.
Schipper
J
J
Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde und Poliklinik, Universitätsklinikum Freiburg. schipper@hno.ukl.uni-freiburg.de
Maier
W
W
Arapakis
I
I
Spetzger
U
U
Tatagiba
M
M
Laszig
R
R
D000236:Adenoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002817:Chordoma / Q000601:surgery; D003388:Cranial Fossa, Posterior; D004388:Dura Mater; D005350:Fibroma / Q000601:surgery; D006801:Humans; D007400:Interprofessional Relations; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000601:surgery; D008579:Meningioma / Q000601:surgery; D009303:Nasopharyngeal Neoplasms / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009777:Occipital Bone / Q000002:abnormalities; D010255:Paranasal Sinus Neoplasms / Q000601:surgery; D010579:Petrous Bone; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D011787:Quality of Health Care; D012449:Safety; D019292:Skull Base Neoplasms / Q000601:surgery; D012888:Skull Neoplasms / Q000601:surgery; D025321:Surgery, Computer-Assisted / Q000379:methods / Q000592:standards; D013997:Time Factors; D036542:Tomography, Spiral Computed