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Experience with the Artis zeego in Orthopedic Trauma Surgery Prof. Gebhard at the University of Ulm is a pioneer in computer assisted surgery. He uses the system for pelvis fractures, tumor surgery, and spinal diseases. Pelvis fractures are often asscociated with threatening vasculare damage. The Artis zeego offers not only an image of the pelvis in one shot but also one-stop treatment for critical patients. Artis zeego provides good spatial resolution and great image quality. Especially for the thoracic spine or in obese patients this can be very beneficial. Scoliosis surgery takes place across large areas of the spine. The system facilitates such surgery with its large field of view, large volume imaging, and spine composing. The wire shown on the image helps the surgeon preoperatively for better orientation. 1 2 3 4 integration of the fixed C-arm system with a surgical table proves to be of great benefit. The sophisticated positioning often needed in orthopedic trauma surgery can be achieved, and images can be acquired in this position by the surgeon moving the system with a joystick (Fig. 1). Highest Hygienic Standards Minimally invasive surgery with only small incisions is also a critical development in orthopedic trauma surgery, and fixed imaging systems like the Artis zeego can provide necessary features such as image quality and stored positions for accelerated workflows. Demographic and lifestyle changes, such as obesity, play an important role. But tumor patients and polytraumatic patients can be treated in a hybrid environment as well. Artis zeego is of class 1a hygienic standard, which is the required standard for orthopedic surgeries. Within a running laminar air field the Artis zeego provides this hygienic standard even in working position. As part of a multidisciplinary project, orthopedic trauma surgeons are often involved in hybrid operating room projects, and they are becoming increasingly aware of Orthopedic trauma surgery is taken to another level using the Artis zeego. An increasing number of installations shows that, specifically for highly sophisticated procedures like scoliosis or pelvis fractures, the system provides a greater safety threshold for both surgeons and patients. Peace of mind at the end of the procedure, soft tissue imaging, and the ability to move the system by themselves are only a few advantages that surgeons appreciate about this new imaging device. Cardiac and vascular surgeries are the drivers for hybrid operating rooms worldwide. It has become a standard and part of guidelines of well-known associations. The Artis zeego provides good contrast to guide the surgical devices, and also provides 3D imaging for specific questions. Different disciplines, especially orthopedic trauma surgery, have noted the benefits of three-dimensional imaging, providing essential image quality. With some 30,000 orthopedic surgeons solely in the US alone, this market represents a great opportunity. As surgeons are used to mobile C-arms with or without 3D capabilities the system takes this kind of surgery to a new level. The this exceptional imaging system. For example at the University of Ulm, Prof. Florian Gebhard, MD, was the lead in the hybrid operating room project (as published in AXIOM Innovations Edition 16, December 2012). He is an early adopter of this new computer assisted surgery concept. He is using Artis zeego especially for pelvis fractures, intraarticular fractures, tumor surgery, and spinal diseases. The large field of view in which an entire pelvis can be visualized in one image and the possibility of soft tissue imaging has helped him to treat more complex patients. Prof. Gebhard has been using the Artis zeego for over one year and highly appreciates the excellent image quality and the opportunity to do a syngo DynaCT at the end of the procedure to verify the position of the screws, change them if necessary, and therefore save the patient from a postoperative CT and secondary surgery in case of misplacement. He is also using the Artis zeego in combination with an automatically registering navigation system. One feature that he is exceptionally fond of is that the surgeon can move the system on his own under sterile conditions at tableside, avoiding discussions with staff when it comes to positioning the system (Fig. 2). 1 2 3A Surgery Orthopedic 60  AXIOM Innovations | December 2013 | www.siemens.com/angiography


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