GPS in surgery?

The term navigation, from the Latin navigatio - sailing, can be defined as 'the art of safe guidance'. On the ocean, a sailor determines his or her position in relation to the sun or moon and the stars. The ancient Greeks could only sail along the coastline because they were unfamiliar with the art of navigation. In the modern world, we associate navigation with a multimedia map that finds our destination in a few seconds and then uses voice commands to guide us to it. It is not only for our convenience that car navigation was developed, but also to save us from wandering around on the roads and to reduce our travel time.

This way of guiding us to our destination increases our safety, as it is easier to listen to voice instructions than to follow the route on a paper map. Exactly the same idea drove the developers of navigated surgery. Its main advantage is that it gets us to the affected area more quickly (which in total reduces surgery time) and increases the precision of the surgical procedure performed.

The concept of determining the topography of individual anatomical elements has found application primarily in minimally invasive procedures and those carried out on a small surgical field.

The aforementioned features are characteristic of ENT procedures. Surgical procedures inside the nasal cavity, sinus surgery or oto-surgery involve very small anatomical structures with a relatively rich supply via nerves and vessels.

What does a medical GPS look like?

Surgical navigation enables the surgeon to pinpoint intraoperatively the exact location in the patient's tissues where the surgical instrument currently in use is located. The navigation system consists of monitoring satellites, reference indicators (items that are placed in the patient's body) and 'markers', which are located on the surgical instruments that allow them to be accurately located in the patient's tissues.

photo: shutterstock

The navigation system provides continuous support to the surgeon, like a pilot sitting in the seat next to the driver. The main task of this system is to combine the 'navigated' image with the endoscopic image. Similar to what happens with our multimedia map that supports our travel. The satellite locates our location, transmits the data to our smartphone and shows it on the display. In surgery, the operator sees on the display screen an image of the specific anatomical structure on which the procedure is currently being performed and the precise location of the microsurgical instruments being used.