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UNIVERSITY OF VIRGINIA PHYSICIAN USES COMPUTER-BASED X-RAY SYSTEM FOR GUIDANCE DURING SURGERY

A physician at the University of Virginia Health System has performed the first surgery using a computer-guided X-ray system. Dr. David Kahler, an orthopaedic surgeon at U.Va., used the system to stabilize a patient's fractured hip by inserting three screws, with only a few seconds of X-ray time.

X-ray images of the patient taken in the operating room are stored in a computer workstation. A camera attached to the computer then tracks both the patient and the surgical instruments in the operating room. This allows the surgeon to see the position of instruments, such as orthopaedic drills and pins, in relation to the patient's fractured bone by simply watching the computer screen.

Recently, there has been some concern over the amount of radiation produced by portable X-ray machines. Some procedures require several minutes of radiation exposure, and each minute is equivalent to several hundred X-rays. Radiation exposure to the patient is clearly an issue, and there is also growing concern about the cumulative effects of radiation exposure to surgeons' hands and eyes, said Dr. Kahler. This is way of using computer technology to perform a standard, familiar procedure in a non-standard way. We think it will have great benefit in reducing exposure to potentially damaging X-rays as well as reducing anesthesia time.

Minimally invasive surgery has been a growing field of surgical research over the last few years. The advent of minimally invasive techniques, such as arthroscopy, for examining the interior of a joint, and laparoscopy, for examining the interior of the abdomen, has made it possible to perform complex operations through small incisions, decreasing the time for healing and reducing complications. For the past two decades, orthopaedic surgeons have routinely used image intensifiers, or portable X-ray machines, in the operating room to guide placement of orthopaedic implants during minimally invasive procedures. This technique is particularly useful in treating hip and leg fractures. Close to one million procedures are performed in the United States each year.

U.Va. is conducting a clinical trial to compare the results of the new technique with the older method. Patients who come to U.Va. Health System with a hip fracture will have the option of being entered into this clinical trial.

October 5, 1999