title: A novel navigation system to guide metallic foreign body extraction.
abstract: OBJECTIVE
  Metallic foreign bodies (MFBs) retained in soft tissue may pose potential threats to patient health. Interventional procedures using conventional navigation systems are associated with high rate of radiation exposure. We postulated that the surgical approach visualization and navigation system would offer precise percutaneous localization and linear guidance with reduced radiation dosage and system complexity.
  
  
  METHODS
  In total, 76 patients underwent percutaneous MFB extraction with the technique, which consists of: (A) displaying the target spot (here the MFB) on the screen; (B) projecting the laser beam onto the skin surface; (C) indicating the optimal direction and angle of the needle; and (D) guiding the surgical approach until the MFB was extracted.
  
  
  RESULTS
  A total of 76 MFBs were successfully extracted with a single operation. No systemic complications were observed. The procedure took between 2 and 11 min, with an average of [Formula: see text] min, demonstrating the characteristics of a normal distribution. The mean size of wound was [Formula: see text] mm. The mean amount of bleeding was [Formula: see text] ml. The number of times the intra-operative fluoroscopy was used ranged from one to four times for a single procedure, with an average of 1.89 ± 0.74.
  
  
  CONCLUSIONS
  The proposed navigation system which combines the laser positioning and navigation techniques seems to be a novel surgical approach of high accuracy and efficiency.
authors.affiliation: The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China. hebin988@163.com.
authors.forename: Bin
authors.initials: B
authors.lastname: He
authors.affiliation: The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Xu
authors.affiliation: The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China.
authors.forename: Yingdelong
authors.initials: Y
authors.lastname: Mao
authors.affiliation: HangZhou Santa Medical Technology Co., Ltd, Hangzhou, 310005, China.
authors.forename: Jingwen
authors.initials: J
authors.lastname: Mao
authors.affiliation: HangZhou Santa Medical Technology Co., Ltd, Hangzhou, 310005, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Shen
authors.affiliation: The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, 310005, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wei
authors.affiliation: Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, 200433, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, 200433, China.
authors.forename: Shuogui
authors.initials: S
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001415:Back; D002648:Child; D002675:Child, Preschool; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005547:Foreign Bodies / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011829:Radiation Dosage; D025321:Surgery, Computer-Assisted / Q000379:methods; D034941:Upper Extremity; D055815:Young Adult
keywords: Metallic foreign body extraction; Navigation system; Radiation exposure; Surgical approach visualization