Computer-Navigated Surgery

Computer-navigated surgery uses computer technology to assist in surgical procedures.

It is also known as computer-assisted surgery (CAS), and is revolutionizing surgery by bringing precision surgical technique and approaches to even the most difficult-to-treat areas.

What It Does
A key component of CAS is diagnostic imaging—using technologies like:

• Computerized tomography (CT) scan
• Magnetic resonance imagining (MRI)
• X-rays
• Ultrasound

These diagnostic technologies allow doctors to get an accurate visual model of the patient, and through the use of data fusion.

Data fusion is a model 3-D dataset formed that gives the exact position of structures and tissues of the patient, including normal and diseased tissues.

This 3-D model then undergoes image analysis using specialized computer software that allows your surgeon to readily view you from any angle and depth.

This enhanced visibility lets your surgeon make a more effective diagnosis, and also allows for virtual simulation of surgery before the actual procedure takes place.

This can be pre-programmed into the surgical robot.

Navigated Surgery
With the help of the 3-D model, image analysis, and the surgical robot, your surgeon then may operate effectively with the device, which looks something like a robotic arm.

There are three main types of robotic surgery, including:

• Supervisory-controlled: In this approach to robotic surgery, the surgical robot performs the pre-programmed procedure
• Telesurgery (remote surgery): In this approach, your surgeon manually controls the robotic arms, rather than using a pre-programmed routine
• Shared-control: This type of procedure involves your surgeon precisely controlling the robot arms using technology that uses an active constraint system that offers support and stability for the surgeon

What is Active Constraint?
Active constraint is a way of defining surgical regions in a patient in one of four categories:

• Safe: Main focus of the surgery
• Close: Area bordering soft tissue. The robot pushes back against your surgeon’s hand if they are in the close area
• Boundary: The area nearest to the soft tissue, which offers the most resistance to your surgeon’s hand
• Forbidden: The soft tissue area itself, where the surgical robot locks into place, preventing surgery in that area

Active constraint is made possible by the careful imaging and navigation of the patient, with the data entered into the surgical robot.

Advantages of CAS
The extensive computer imaging of the patient allows your doctor to get the most accurate diagnosis, which aids in pre-operative planning of the surgery.

The precise control of the surgical robot makes your surgeon’s work easier, giving more control, reducing operating time, and reducing the risk of surgical errors.

The telesurgical and supervisory-controlled approaches are getting most of the attention, but shared-control CAS will become more prominent as robotic surgery and diagnostic imaging technology continues to advance, providing surgeons with state-of-the-art surgical tools to more effectively treat challenging diseases and conditions.