Computer-assisted surgery: Beyond the limitations of human motor function

Released September 18th, 2009 Interview with Dr. Gero Strauß, ENT surgeon and director of the International Reference and Development Centre for Surgical Technology (IRDC) in Leipzig on the potential of computer-assisted surgery. For about ten years, Dr. Strauß has been working with and advancing high-tech assistance systems.

In what way is the use of a computer-assisted system superior to working without support?

Strauß: The limitations posed by human motor function are exceeded with such systems. With technical assistance, the surgeon can perform extremely precise movements that are otherwise impossible, even for highly talented surgeons. Navigation system support allows surgeons to choose access routes that were previously too dangerous. High-resolution images reveal much more detail, resulting in more precise coordinates for surgery. Technology compensates for minor weaknesses on the part of the surgeon, and the operator’s performance stays consistently high.

So anyone can become a top surgeon given the right technology?

Strauß: Surgery is performed all the time. In such a widespread profession, quality does vary, and there are differences in performance from day to day. Our goal is making excellent surgeons even more successful with the available technology. Even a top racecar driver would not claim to brake as efficiently and precisely as an anti-lock braking system. No pilot would do without the available support systems when taking off or landing in fog and darkness. The same applies to surgery. However, surgeons must always be certain that they are capable of performing a procedure. No computer in the world can replace experience and intuition. The surgeon bears the responsibility and must be able to manage if the navigational system fails - just like a pilot would if the autopilot system broke down.

What additional advantages do these new, modern systems offer to patients?

Strauß: Primarily additional safety and fewer associated injuries. In my specialty , the complication rates are below five percent. Our goal is the further improvement of these rates. Another key advantage is the increase in transparency. Many patients would like to know exactly what will happen in the OR. I take them onto virtual flights through their paranasal sinuses, navigate to behind the eardrum and zoom onto the larynx. These pictures say more than a thousand words. They increase trust, and conversations with the patient become much more enjoyable.

The IRDC features two brand new, high-tech OR 1 operating rooms made by KARL STORZ. Given all this high-tech equipment, what aspect is particularly exciting to surgeons?

Strauß: The first impression of the modern, uncluttered and conveniently arranged workspace. Everything is suspended from the ceiling without mess or tangled cables. Lights and monitors are perfectly harmonized. The feel of the working environment is most impressive. Many colleagues have commented on that. Then, there is the seamless integration of the OR into the logistics system. For example, one can find out anytime where a special instrument is located on its way from processing to the OR. Resources can be precisely planned, which saves money

Which areas have experienced the greatest technological progress?

Strauß: There has been major progress in the underlying data for the individual “map” of each patient. With CT, MRI and PET, the quality of imaging systems has greatly improved. Resolution has increased by a factor of 10 to 100. This is essential for surgical navigation systems. While in the 1980s, the CT had to run for one hour to generate 20 images, it now creates 800 or more images of one area of the body in less than ten seconds. What’s more, such devices are not only available at the Max-Planck-Institut, but they can be found in normal radiology offices.

Will computers do surgery without physicians in the future?

Strauß: No way. Some wrong turns were taken in the pioneering years of computer-assisted surgery, and development was often too technology-driven. It is often the case that many options are explored when ideas are new. To me, high-tech systems are important assistance technologies, such as the anti-block braking system or acoustic distance warning systems in cars – but that’s all they are. Such assistance systems do not replace the driver. Moral and ethical aspects also play a role in this context: To what degree do we trust a machine to perform a procedure; how much responsibility are we prepared to delegate? An airplane could fly without pilot as well, but few people would volunteer to be passengers.

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For questions and appointments for interviews, video and foto sessions, please contact:

PD Dr. Gero Strauß
Direktor IRDC
Käthe-Kollwitz-Straße 64
04109 Leipzig
Fon: +49 (0)341 – 33 73 31 60
Fax: +49 (0)341 – 33 73 31 63

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