Image-guided surgery uses preoperative images to create a three-dimensional view inside the patient to help the doctor navigate during surgery. It requires extensive preoperative planning, but can shorten time in surgery, make procedures less invasive, and reduce risks for the patient. Originally developed for neurosurgery, it has been extended to procedures in the sinuses as well as other parts of the body. Not all facilities offer this option to patients, and if someone is interested in it, it is advisable to ask for a referral to a surgeon who works with image guidance technology.
This technology is similar to that used with Global Positioning Satellites (GPS) and topographic navigation. Before the image-guided surgery, the patient undergoes a medical imaging study used to create a series of internal slices that can be used to build a picture of the inside of the body. In addition, laser registration of the outside of the patient’s body is used to create a series of reference points for navigation. These can be calibrated with the instruments used in surgery.
As a surgeon approaches a procedure like brain tumor removal, a hand-held probe displays the patient’s anatomy on screen, along with an overlay from the preoperative images. Before the surgery, the doctor has an opportunity to review these images and plan a precise path, programming it into the equipment. The probe guides the surgeon, making it possible to avoid sensitive areas. Image-guided surgery can also help with tasks like completely excising tumor tissue when it may be hard to tell the difference between cancerous cells and healthy ones just by looking.
In sensitive areas like the sinuses or inside the brain, image-guided surgery can provide a number of benefits for patients. Historically, surgical planning involved looking at some static images of the patient and relying on a general knowledge of anatomy to decide how to proceed. With image guidance, surgeons have an anatomical reference specifically keyed to the patient, which increases accuracy. It can also mean that the surgeon spends less time in the operating room, because pre-surgical planning makes the patient’s anatomy familiar.
If a facility offers image-guided surgery, patients should plan on some extra imaging sessions to acquire data that will be used during surgery. It may also be possible to look at the pictures and discuss the plan with the surgeon, who can trace the path that will be taken in the operating room. Patients sometimes find it helpful to know more about how their procedures will be performed, as this can make the prospect of surgery less frightening.