Informations-assistierte Chirurgie als ein transdisziplinäres Operationsverfahren

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. Method: We analyzed the possibilities for the application of IAS in interdisciplinary transfacial surgergy 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. Conclusion: Even though the highly-developed technology of IIAS - intelligent information assisted surgery - is available, with the possibility of half or fully automatical implementation of IIAS including a automatical re-referencing, this technology will not be used in medical navigation for strategic reasons.