A novel vacuum immobilization device and a novel targeting device for computer assisted interventional procedures

摘要

Our purpose was the development and evaluation of a patient immobilization device and an aiming device for frameless stereotactic interventional procedures in various body regions. For the CT scan the patient is placed upon a vacuum mattress, wrapped up with special cushions and covered with a plastic sheath. When the vacuum pump is turned on the cushions harden and the patient is sucked against the CT couch resulting in patient immobilization. After the scan the Vertek targeting device is adjusted using the StealthStation navigation system. The aiming device allows for precise alignment of the probe of the navigation system with the preplanned trajectory. The needle is advanced through the aiming device to the target. The novel technique was used for bone-tumor biopsies in 5 patients, vertebral-disc biopsy in two patients and -with a different immobilization technique- retrograde drilling of osteochondral lesions in the talus in 12 patients. Image-fusion revealed a needle displacement within 2-4 nuns in all patients. The whole procedure including immobilization, general anaesthesia, adjustment of the targeting device and tissue sampling took about 1-2 hours per patient. Application of navigation systems in combination with the novel devices allows for precise puncturing of different targets in the body.