Computer aided navigation is an interesting concept. However,
there is no evidence that it leads to better clinical outcomes and fewer
failures. On the other hand, there is ample evidence that surgeon experience has
a dramatic effect on outcomes and complications.
One way to conceptualize this is that the experienced
surgeon’s brain is a computer with much more sophisticated
"software" than a navigation computer. When a computer is
programmed, an algorithm must be created which has certain
inherent limitations. Furthermore additional significant
sources of errors are introduced by the registration of
anatomic points for the navigation computer in surgery.
My personal opinion is that navigation that is based on a
pre-operative CT scan data, which is being pioneered by
Justin Cobb, has tremendous promise in the future to improve
the results. At this point, we are still in the early
development phase. It will probably add several thousand
dollars to the cost of each operation.
In summary, I believe the right kind of navigation surgery
based on accurate 3D CT scans holds tremendous promise for
the future. It will still require an extensive amount of
preliminary development work before it is ready for routine
I hope this helps with this very complex issue.
Thomas P. Gross, M.D.