Mobile C-arm-Radiation exposure and workflow killer? : Potential of an innovative assistance system for intraoperative positioning

Abstract

Despite its versatile applicability the intraoperative use of amobile C‑arm is often problematic and potentially associated with increased radiation exposure for both the patient and the personnel. In particular, the correct positioning for adequate imaging can become aproblem as the nonsterile circulating nurse has to coordinate the various maneuvers together with the surgeon without having agood view of the surgical field. The sluggishness of the equipment and the intraoperative setting (sterile borders, additional hardware, etc.) pose further challenges. Alight detection and ranging (LIDAR)-based assistance system shows promise to provide accurate and intuitive repositioning support as part of an initial series of experimental trials. For this purpose, the sensors are attached to the C‑arm base unit and enable navigation of the device in the operating room to astored target position using asimultaneous localization and mapping (SLAM) algorithm. An improvement of the workflow as well as areduction of radiation exposure represent the possible potential of this system. The advantages over other experimental approaches are the lack of external hardware and the ease of use without isolating the operator from the rest of the operating room environment; however, the suitability for daily use in the presence of additional interfering factors should be verified in further studies.