Two German companies have agreed to integrate technologies with the goal of giving surgeons better orientation in the operating room (OR) and enabling minimally invasive surgeries with less radiation and higher accuracy.

Ziehm Imaging (Nuremberg, Germany), a provider of mobile imaging solutions for healthcare, and BrainLab (Munich, Germany), a manufacturer of software-driven systems for targeted, less-invasive medical treatments, reported a development and marketing agreement for the integration of mobile 3-D C-arms and Computed Assisted Surgery (CAS).

Financial terms of the agreement were not disclosed.

In 2002, Ziehm and BrainLab jointly pioneered the development of DICOM-based CAS on 2-D fluoroscopic images, the companies noted. Now, both companies plan to establish full compatibility of Vario 3-D and Vision 3-D —Ziehm’s C-arms — with all mobile BrainLab platforms for 3D intra-operative imaging.

Speaking to Medical Device Daily from Munich, Claus Schaffrath, MD, director of marketing orthopedic solutions for BrainLab, said that 3-D imaging is an opportunity for the surgeons to be “really safe” and know, at the end of the surgery, that they have “done a good job.”

Schaffrath’s background is in both medicine and electrical engineering and he worked as a neurosurgeon before he worked with BrainLab.

“I believe that at least for the procedures in spine and trauma surgeries 3-D imaging is becoming more and more important,” Schaffrath said.

Previously, surgeons had to wait to verify their results with 3-D imaging post-operatively, by having the patient undergo a computed tomography scan a couple days after surgery. Then, if a problem is found, Schaffrath said it can be “quite embarrassing” to have to go back to the patient and explain that another revision surgery is required.

“With intra-operative imaging you can prevent that,” he said. “Because once you think you’re done, you can do another scan to be sure you’ve done a good job.”

Vario 3-D, Vision 3-D and BrainLab CAS platforms are designed to assist with a variety of procedures, including spine and trauma, craniomaxillofacial and neurosurgical operations.

According to the companies, Vario 3-D and Vision 3-D allow surgeons to create a volumetric 3D dataset with arbitrary numbers of fluoroscopic images. Depending on each indication, the surgeon can define the image quality, radiation dose and the resolution of the images.

“With 3-D intra-operative imaging you get better visualization of, say, a broken structure,” Schaffrath said.

Where BrainLab’s technology comes into play, Schaffrath said, is that the OR staff can automatically register intra-operatively acquired 3-D datasets and upload the information into the CAS system, saving OR time. During surgery, the position of the patient and the surgical instruments are tracked in real time through BrainLab software, the company said.

“We see the market for 3-D intra-operative imaging gaining significant momentum,” Schaffrath said. “Customer demand clearly indicates the value of an ergonomic combination of imaging and navigation, which leads to reduced radiation, increased precision and, ultimately, improved outcomes. By cooperating with Ziehm we are strengthening our position in this market.”

Ziehm makes mobile X-ray-based imaging solutions. BrainLAB develops software-driven technology designed to enable procedures that are more precise, less invasive and less expensive than traditional treatments.

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