Surgical Navigation System's Streamlined Design Eases Operating Room Headaches

Originally Published MDDI June 2002

MEDICAL DESIGN EXCELLENCE AWARDS 2002

StealthStation Treon Treatment Guidance System (Treon)

Submitted by MPE-Inc. (Milwaukee); manufactured by Medtronic SNT (Louisville, CO)

For more than a decade, surgeons and clinicians have embraced surgical navigation systems for their ability to translate patient scan data into three-dimensional images that doctors can follow during surgery, all while lamenting the systems' traditional bulky dimensions.

Before the invention of such systems, surgeons operating on the brain or spine would have to mentally judge how to perform a procedure—the best place to enter the body, the best route to the tumor, etc. With surgical navigation systems, a patient scan from an MRI or CT is downloaded and translated into a 3-D map of the site. Surgeons then can view the data and consider software recommendations when developing their surgical plan. They also can perform "virtual fly-throughs" of the surgery and make adjustments as they settle on the optimal path.

During actual surgery, a camera is aimed so that the patient's current position is overlaid on the image from the MRI or CT. The movements of the surgical instruments are tracked, showing the surgeon how to proceed according to his or her previously outlined plan. As a result of this technique, surgeries now involve less guesswork, and surgery and recovery times have been reduced.

However, in conversations with neurologic and orthopedic surgeons, Medtronic SNT learned that users had some complaints about the systems—namely, that they're too large and bulky and difficult to use.

Most systems consist of two carts. One is a "viewing" cart with a monitor display that is placed near the head of the OR table so that the surgeon can monitor the movements of the surgical instruments in the patient's body. The other is a "navigation cart" that holds the camera and usually sits at the foot of the table.

Medtronic's new StealthStation Treon Treatment Guidance System (Treon) addresses users' needs in several ways. The carts were designed to be about half the size of those used in other systems. A new dockable design allows the carts to function separately (useful when a surgeon wants only the viewing cart nearby to follow a preoutlined surgical plan).

"We strongly considered user feedback and thought about how the equipment would be used both in and out of surgery while we were redesigning it," says Eric Ryterski, principal engineer for Medtronic SNT. "Users said that storage and transportation of the equipment has been a hassle, so we developed carts that snap together to move around as one, and when you pull a lever, they separate so that they can be positioned properly during surgery. And the system is fully functional in both configurations in case users would prefer just one piece of equipment in the OR.

"One of our greatest achievements was in refining the 'arms' that hold the camera on the navigation cart," Ryterski continues. "In the OR, there's a lot of equipment in the room, and users needed more flexibility in positioning the camera. The camera now can be rotated and positioned along a 24-in. horizontal axis and a 12-in. vertical axis, which lets users see the patient over other equipment, such as an anesthesiology cart. To aid in setup, we added a laser pointer that lets users accurately aim and position the camera without the full system being turned on."

The viewing cart was reconfigured as well. It now features an extendable neck that allows the display to be positioned 18 in. from the cart, so that the cart can be placed further from the operating table. A touch screen and accompanying stylus now allow the surgeon to touch the monitor without adding sterile drapery that would reduce image quality on the monitor.

MDEA jurors agreed: Space is at a premium in the OR, and the newest generation of Treon delivers an easier-to-position product that better meets surgical needs.

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