Adapting the fluoroscope to image-guided surgery.

Abstract

Image-guided techniques have been well established in all surgical disciplines for years. To achieve an optimised work flow during image-guided surgery, the surgeon should be able to manipulate the visual feedback and therefore the imaging unit. C-arm fluoroscopy is the imaging modality routinely used for intraoperative imaging in orthopaedic surgery. The C-arm fluoroscope is positioned and handled by a radiographer on vocal commands, which means that the surgeon depends on external help to manipulate the visual feedback and the work flow is not optimised. The MEPUC interface adapts the C-arm fluoroscope to the needs of image-guided orthopaedic procedures. MEPUC is an acronym for Motorised Exact-Positioning Unit for C-arm. In the hardware component of the MEPUC a conventional C-arm fluoroscope is equipped with stepping motors. The software component allows the surgeon to control the motorised movements of the fluoroscope. The MEPUC interface enables the surgeon to position the C-arm fluoroscope independently in the operating room. Further advantages are achievable when the MEPUC interface is combined with surgical navigation, as this combination allows fully automatic reproduction of former projections. Clinical experience with the MEPUC interface suggests that the work flow for intraoperative imaging is improved and personal requirements reduced.