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A new image-guided surgery system at York Central Hospital using 3-D imaging is making sinus surgery, a sometimes risky procedure, much safer.

The hospital purchased equipment worth more than $100,000 to help with procedures such as cosmetic, plastic and reconstructive surgery for benign and cancerous tumors of the sinuses, said Philip Solomon, a head and neck surgeon at the hospital.

The equipment is also useful for patients who already have had several operations. The new system allows doctors to navigate through the nasal passage and locate the surgery site with great accuracy, Dr. Solomon said.

This new technology allows us to calibrate the instruments we use during surgery so that one can pinpoint where they actually are working on the patient, relative to the images,as he said.

This provides an extra layer of safety in this surgery, which can be complicated and risky in some circumstances. During a procedure, doctors use images from a CT scan (taken before the surgery) to build a 3-D model of a patient’s head. That image is then matched to the patient’s anatomy during the procedure.

Dr. Krzysztof Conrad (from left), ear, nose and throat resource nurse Heather Gordon, Dr. William Kaul, operating room manager Pam Richards and Dr. Philip Solomon showcase an image-guided sinus surgery system at York Central Hospital.

The equipment, called the LadmarX system, also acts as a global positioning system and surgeons can precisely locate their instruments within the patients body. Older technology saw doctors use static, two dimensional images when manipulating surgical instruments.

That’s the big advantage of this, said Dr. Solomon. It shows us where we are relative to the images, rather than us guessing.
About 50 patients so far have received treatment using the technology. The surgeon is able to home in on tumors and lesions or drain inflamed sinuses while avoiding damage to surrounding tissue or critical areas.

Surgery in the region can pose risks due to the small space doctors operate in, as well as the proximity between the sinus region and the brain and eyes. We are talking millimeters, Dr. Solomon said. Three surgeons, Dr. Solomon, William Kaul and Krzysztof Conrad, use the equipment at York Central. The image-guided technology was developed for neurosurgery, but is now used mostly for sinus surgery.

The hospital gets referrals for the surgery from across York Region, as well as Toronto and the west side of the GTA, Dr. Solomon said. Only a handful of doctors are trained to use the technology and a small number of facilities have the equipment. Students from the University of Toronto have also trained to use the equipment, and the technology will likely become the standard of care, Dr. Solomon added.

Regional News
Aug 29, 2007 09:45 PM

By: Michael Power

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