Training arthrocentesis and arthroscopy: Using surgical navigation to bend the learning curve

Abstract

ObjectiveTemporomandibular joint arthroscopy and arthrocentesis are generally considered safe and minimally invasive surgical procedures. For an inexperienced surgeon, the complex anatomy of the surgical field and the limited visibility represent a significant challenge, and many surgical training programmes are considered limited in providing the adequate training.Technological advancements, involving surgical navigation, facilitate planning, execution, and evaluation of various complex surgical treatments and represent a very promising addition to the surgical training toolkit. TechniqueThis article presents the use of surgical navigation as an additional training tool in teaching level I and II arthroscopy to resident surgeons. Surgical navigation is used to aid the trainee by controlling the starting point and angulation, inspect anatomical landmarks and discus consequences of errors in angulation. While the trainee performs the puncture, the instructor oversees both the surgical field and the anatomy on the surgical navigation screen. ConclusionIt is demonstrated that real-time guidance provided by a surgical navigation system can be used as a training tool for surgeons with limited previous experience in arthroscopic procedures. This application could help improve the safety for the patient and provide a deeper educational level in training surgeons. Still, clinical and tactile feedback perioperatively should remain a primary guideline. Factors such as financial investments, challenges in implementation and a steep learning curve regarding the navigation system must be considered.