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By Gloria Butler Baldwin
Clarion-Ledger Staff Writer
July, 28 1998

Breathing just got easier for people suffering from sinus troubles.

The Insta-Trak System, now in operation at River Oaks Hospital, uses advanced, three-dimensional computer imagine to make the traditional endoscopic sinus surgery safer and more effective.

Dr. Peter Casano, a head and neck surgeon at River Oaks, said it takes the guesswork out of a popular procedure. “Six percent of annual office visits to primary care physicians are due to sinus disorders,” said Casano. “All of them don’t require surgery, but for those that do, the InstaTrak makes it more accurate and easier for the surgeon to see where he is.”

In traditional surgery, endoscopes are used to illuminate the area inside the sinuses.

While the devices provide a detailed surface view, they can’t peer around corners or locate surgical instruments in relation to the anatomy.

A monitor shows a
color image of a sinus
surgery site.

Photos by
J.D Schwalm
The Clarion-Ledger

Radiology helps surgeons make an educated guess on the location of vital areas. However, if they get too close, they could damage sensitive tissues such as the eyes or brain; if they don’t get close enough, they may miss part of the problem, such as a polyp or cyst.

With InstaTrak by Visualization Technology Inc., space-age imaging augments the surgeon’s limited vision by combining the advantages of a CAT scan and endoscopic imaging into a picture. A brief in-service training on the equipment is all that is required for surgeons to use the picture-in-picture technology.

Since June 4, seven sinus surgery procedures have been performed at River Oaks.

Dr. Maurice Ferre, president and CEO of VTI, developed the idea of merging his two loves, supercomputing and medicine, while in medical school. “This is helped by the trend of everyone going to less invasive surgery,” said Ferre of Boston. “Although the InstaTrak specifically is designed for sinus surgery, we’re doing research now on pituitary surgery, going through the nose to do brain surgery. The device could also be used to operate on the spine and heart.”

Ferre said the image-guided surgery market is estimated to grow to $1 billion by 2000.

InstaTrak creates a computerized model of the patient’s skull using CAT (computed tomography) scans taken before surgery. The model acts as a road map for the surgeon.

The endoscope and a probe, part of InstaTrak’s magic, are inserted into the nostril. The probe appears as a set of cross hairs on the cat scan image on the monitor and shows the surgeon exactly where the instrument is in relation to the anatomy.

Although it is River Oaks Hospital policy not to release facility costs, Casano said using InstaTrak costs about $400 more than the traditional procedure using the endoscope alone. But patients don’t seem to mind, if it gets them out sooner and there is less chance of recurrence.

Steven Fulgham of Ridgeland, had his surgery July 20 and was Casano’s second patient to receive the benefits of InstaTrak technology.

“I’ve had sinus trouble for years and am tired of taking antibiotics that don’t work,” said Fulgham. “I was ready to have the surgery. Looks like this is a good time to have it with this new equipment.”

Casano said patients wouldn’t notice a difference in recovery time since the removal of the problem is performed the same way. However, since the equipment does allow the surgeon to be more accurate in getting out all the problem areas, recurrence is minimal.

But the InstaTrak is not for everyone. The InstaTrak cannot be used on patients who have electronic devices that connect directly to the brain or nervous system.

“In a few years, it will be the standard of care for sinus surgeries,” Casano said.

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