Author(s)
Thomas Breinlich, MD
Valentin Breinlich, MD, MBA
Affiliation(s)
HNO Praxis Ludwigsburg; RKH Klinikum Ludwigsburg; Siloah St. Trudpert Klinikum Pforzheim;
Abstract:
As an ENT physician with admitting privileges at the ENT Department of the Hospital Ludwigsburg (now: RKH Holding Klinikum Ludwigsburg) I introduced Image Guided Surgery ("IGS") in 2011.
The system used was the Karl Storz Surgical cockpit NPU, an optical based IGS.
I performed a prospective study of the first 24 patients and gave a presentation about my first 24 patients looking at the aspects of cost and utility at the Annual Meeting of the AAORLHNS in Washington DC 2012.
I continued with 115 more consecutive patients until september 2015 and looked at changes concerning safety, cost and utility after those 4 years.
Cost is the time I needed to start the system, transfer the data and define the registration points (tecnical setup time "tst" and the time needed to verify those points on the patient (patient related setup time "pst").
This work has to be done by the surgeon himself and therefore is of importance to my workflow.
Utility is measured looking at minor or major complications and the perceived benefit of the practicioner to perform a safe and complete surgery, even in complicated cases (multiple revisions, mucocele surgery, tumor surgery).
After those 4 years where every patient underwent FEES using Image Guidance I changed my proceedings to use IGS not on every patient.
It is a extremely helpful in complicated cases (difficult anatomy, multiple revisions, tumor surgery) where this valuable tool is used regularly.