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Brainlab Kolibri cranial Software User's Manual

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Software User Guide
Revision 1.0
Kolibri
cranial/ENT
r
Version 2.7
Copyright 2009, BrainLAB AG Germany. All rights reserved.

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Summary of Contents for Brainlab Kolibri cranial

  • Page 1 Software User Guide Revision 1.0 Kolibri cranial/ENT Version 2.7 Copyright 2009, BrainLAB AG Germany. All rights reserved.

  • Page 3: Table Of Contents

    ......... . 33 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
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  • Page 10 Table of Contents Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 11: General Information

    Topics Covered Section Contact Data & Legal Information page 12 Symbols Used in This Guide page 14 Intended Use page 15 Compatibility with Medical Devices page 18 Training & Documentation page 23 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 12: Contact Data & Legal Information

    Despite careful review, this manual may contain errors. Feedback Please contact us at igs.manuals@brainlab.com if you have suggestions as to how we can improve this manual. Manufacturer BrainLAB AG Kapellenstr. 12 85622 Feldkirchen Germany Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 13: Legal Information

    Kolibri is a trademark of BrainLAB AG, registration pending. Trademarks • ® is a registered trademark of BrainLAB AG in Germany and/or the US. Softouch • StarLink ® is a registered trademark of BrainLAB AG in Germany and/or the US.

  • Page 14: Symbols

    Such problems in- clude device malfunctions, device failure, damage to device or damage to property. NOTE: Notes are formatted in italic type and are used to indicate additional useful hints. Notes Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 15: Intended Use

    • Maxillary antrostomies • Ethmoidectomies • Sphenoidotomies/Sphenoid explorations • Turbinate resections • Frontal sinusotomies • Intranasal procedures Place of Use Kolibri cranial/ENT system is to be used in the operating room. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 16 BrainLAB instruments are designed and manufactured to minimize the risk of damage to the patient’s brain tissue. Therefore, it is unlikely that patient injury will occur during nor- mal instrument use.
  • Page 17 MR Conditional: The number shown on each label specifies the MR envi- ronment in which the device can be used with caution <XYmT Plausibility Review Before patient treatment, review the plausibility of all information input to and output from the system. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 18: Compatibility With Medical Devices

    - Instrument Adapter Arrays (sizes S, M, ML, L, XL) - Instrument Adapter Clamps (sizes S, M, L, XL) • Sterilization Trays (Cranial, ENT, Frameless Biopsy System, VarioGuide) • Suction Tube • VarioGuide • Vario Reference Arm • z-touch Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 19 Other BrainLAB Additional instrumentation may become available after release of this manual. Contact Instruments BrainLAB support if you have any questions regarding instrument compatibility with Brain- LAB software. Only use instruments and spare parts specified by BrainLAB with Kolibri cra- nial/ENT .

  • Page 20: Brainlab Software

    If you are running software versions other than those specified above, please contact Brain- Software LAB support for clarification regarding compatibility with BrainLAB devices. Only BrainLAB medical software specified by BrainLAB may be installed and used with system. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 21: Non-Brainlab Medical Devices

    BrainLAB Devices Using medical device combinations which have not been authorized by Brain- LAB may adversely affect safety and/or effectiveness of the devices and endan- ger safety of patient, user and/or environment. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 22: Non-Brainlab Software

    Compatible Non- Kolibri cranial/ENT BrainLAB Software garding compatible service packs please contact BrainLAB support. Other Non- BrainLAB Software Only software specified by BrainLAB may be installed and used with Kolibri cranial/ENT Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 23: Training & Documentation

    • Simulate a sufficient number of complete procedures on sawbones and/or cadavers. • Use the system in operations where computed-aided navigation may be desirable but not essential. A BrainLAB representative must be present at such operations to provide guidance where necessary.

  • Page 24: Documentation

    They provide condensed information on using the software or hardware, and are intended as a supplement to the User Guides. NOTE: Quick Reference Guides do not replace reading the User Guides. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 25: System Startup & Shutdown

    System Startup & Shutdown System Startup & Shutdown Chapter Overview Contents Topics Covered Section Opening a Session page 26 Shutting Down page 33 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 26: Opening A Session

    Option 2 Next, the scan data and the treatment plan are transferred via an ex- ternal USB flash drive or network to the Kolibri computer. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 27: Starting The Software

    To load patient data and begin navigation using the navigation software, select Naviga- (see page 30). tion NOTE: Availability of the above options depends on your system configuration. If only one application is installed on your system, the application starts automatically. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 28: Workflows For Data Transfer And Planning

    NOTE: For information on transferring data using PatXfer , see the PatXfer Clinical User Guide . For information on planning cranial or ENT treatments using iPlan , see the relevant iPlan Software User Guide . Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 29 Names of objects and trajectories preplanned using iPlan may be shortened in Kolibri cranial/ENT software. Objects (markers, trajectories, outlined objects) preplanned using iPlan which do not belong to the exported image set are not imported to Kolibri Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 30: Workflow For Navigation

    (See page 31 if multiple pa- tients are available on the network. See page 32 if one patient is available on the net- work). To exit the procedure, press to open the dialog. Cancel Close Program Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 31 Network Patient Load Overview patient data sets (sorted by date). Select the correct patient from the list. Review the data in the Patient Information dialog (see page 32). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 32: Loading Patient Data

    Image sets which were localized with the soft- VectorVision Cranial Planning 1.3 ware, or where the scaling feature of the image fusion was used, cannot be load- ed to Kolibri cranial/ENT 2.x Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 33: Shutting Down

    Always close the software before shutting down the system. Never use the power switch to exit the software, as data may be lost. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 34 Data stored to CD can be used for archive purposes only. NOTE: Screenshots taken in iPlan are not exported to the navigation system. To store screenshots created using iPlan , open the Windows Explorer, go to C:\brainlab\screenshots and copy the screenshots to another storage medium.
  • Page 35 Turn off the system (see System User Guide Storing Upon closing the software, all screenshots acquired during the session using the Screenshot Screenshots button are automatically saved to the storage medium. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 36 Shutting Down Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 37: Software Overview

    Software Overview Software Overview Chapter Overview Contents Topics Covered Section Introduction page 38 User Interface page 39 Tracking System page 43 System Information and Configuration page 50 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 38: Introduction

    The actual anatomy of the patient could differ from the preoperative scan data due to e.g. brain shift or resections. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 39: User Interface

    The main screen opens once patient data has been loaded. Figure 6 Explanation Patient’s name Image Views page 111 Camera view windows page 44 Camera status bars page 45 Menu bar page 40 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 40: Menu Bar Overview

    Adjusting Views Button Function Windowing allows you to adjust windowing in image sets page 127 buttons change the magnification of displayed Zoom page 117 images Freeze locks the navigated display page 160 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 41 169 cally removed tissue volumes General Functions Button Function Screenshot takes a screenshot of the current screen page 117 The shutdown button shuts down the software page 33 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 42: General Dialog Buttons

    Allows you to repeat a step Exits the dialog without applying changes Exits the dialog NOTE: Additional buttons with specific functionalities are described with the correspond- ing step in this guide. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 43: Tracking System

    Dots in the display indicate the relative positions of instruments and reference arrays that are visible to both camera lenses. Status Displays Figure 7 Component Camera view windows Status bars Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 44 Otherwise the system may not be able to differentiate between instru- ments, resulting in incorrect instrument navigation. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 45 Camera communication error during startup. If camera Both Black communication fails during use, a warning message ap- pears. Once a status bar is yellow, accurate tracking can no longer be guaranteed. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 46: Tracking Instruments

    Biopsy Alignment Array/VarioGuide • Microscope Adapters NOTE: To update the navigation views to the position of a lower priority instrument, re- move the instruments of higher priority from the camera field of view. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 47 Do not use pointers, microscope adapters or instrument adapters of the same size simultaneously as the navigation software cannot distinguish between the individual calibrations of identical geometrical arrangement of marker spheres. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 48: Camera Positioning

    ) should be as close to the center as possible, so that there is sufficient space for navigation instruments. If an array is no longer visible to the camera, the spheres disappear from view in- dicating that the array can no longer be tracked. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 49 Explanation High pitched Reference array is close to the center of the camera field of view Low pitched Reference array is further from the center of the camera field of view Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 50: System Information And Configuration

    System Information and Configuration System Information and Configuration Overview About System A BrainLAB support specialist performs the initial system configuration. You can configure Configuration additional settings in the dialog. Tools Tools Dialog Figure 10 Function Hotline provides access to: • BrainLAB support and hotline numbers •...

  • Page 51: Adjusting Sound Settings

    To activate sound when you press buttons, toggle Button Sound to on (yellow frame) or off (blue frame). Select volume level by adjusting the Sound volume level slider bar. Press to apply settings and close the dialog. Close Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 52: Configuring A Live Video Connection

    Connect the cable between the video source and the navigation system, following the in- structions in the relevant BrainLAB System User Guide and the user manual for the video source. Make sure that you have a signal in order to adjust the video settings.
  • Page 53 Gamma brightness. Increasing gamma increases overall brightness with a slightly greater effect on mid-tones. NOTE: This setting is available for microscope video views (see page 220). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 54 System Information and Configuration Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 55: Registration Overview

    Registration Overview Registration Overview Chapter Overview Contents Topics Covered Section About Registration page 56 Preparation for Registration page 58 Restoring a Previous Registration page 60 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 56: Introduction

    The patient’s actual anatomy could differ from the preoperative scan data, due to e.g., brain shift or resections. Before You Begin Refer to the Instrument User Guide for complete details on registration instruments. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 57 Restore Registration Restore an already performed registration Acquire landmarks to use for intraoperative registration Acquire Intraoperative Landmarks (available if registration has already been performed) Register Intraoperative Register intraoperatively acquired landmarks Landmarks Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 58: Preparation For Registration

    Explanation High pitched Reference array is close to the center of the camera field of view Low pitched Reference array is further from the center of the camera field of view Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 59 The camera and/or the z-touch may affect the infrared detectors of devices (e.g., OR tables, remote controls, etc.). Verifying Accuracy Always verify the registration accuracy as prompted by the software. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 60: Restoring A Previous Registration

    In the Patient Registration dialog, check the accuracy of the restored registra- tion. Patient Positioning Do not restore a registration if the patient position has changed relative to the reference array. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 61: Standard Registration

    Standard Registration Standard Registration Chapter Overview Contents Topics Covered Section Introduction to Standard Registration page 62 Performing Standard Registration page 65 Registration Accuracy page 73 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 62: Introduction To Standard Registration

    This meth- Sequential od is also activated if unsequential registration fails. Registration You must register markers/landmarks in the order defined by the software. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 63 If markers are still attached, remove them now, taking care not to burst the green MR markers. Do not remove marker plates from the patient until patient registration has been performed. Otherwise, standard registration is not possible. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 64: Registration Instruments And Software Guidance

    The software emits a beep each time you register a marker or landmark. Cues If you attempt to register the same marker and landmark more than once, the software emits a lower toned “beep” and does not re-register the point. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 65: Performing Standard Registration

    Standard Registration Performing Standard Registration Activating Standard Registration How to Activate Figure 16 Steps Press Register in the menu bar. In the Registration Selection dialog, press Standard Registration Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 66: Planning Registration Points

    Detected markers are shown as red circles in the image set. Previously defined markers in the image set are deleted. NOTE: Automatic marker detection can only be used in combination with BrainLAB mark- ers. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 67 To switch between different markers and landmarks, press Toggle The currently selected marker/landmark is shown as a circled cross-hair in the center of the image set. To remove a marker/landmark, toggle to the marker/landmark and press Delete Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 68 • If the image set contains fiducial markers only, the software prompts you to register the markers using unsequential registration (see page 69). • If the image set contains at least one landmark, the software prompts you to se- quential registration (see page 71). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 69: Unsequential Registration (Registering Fiducial Markers)

    You can register markers in any order. Once you have registered the number of markers indicated at the top of the dia- log, press Proceed Verify registration accuracy in the dialog that opens (page 73). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 70 To proceed using a different standard registration workflow, press Proceed The software prompts you to perform sequential registration (see page 71). If you wish to exit standard registration in order to e.g., perform surface matching regis- tration, press Cancel Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 71: Sequential Registration (Registering Fiducial Markers And Preplanned Landmarks)

    • Landmarks are blue Once you register a marker/landmark, it is shown as a circle. The color representation of the markers/landmarks might be different from those chosen in the planning software. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 72 To repeat registration, press Try Again To add markers to the image set or to redetect markers in the image set, press Define Points The software opens the Registration Points dialog. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 73: Registration Accuracy

    Due to error propagation, navigation accuracy may be degraded compared to the accuracy achieved at the landmark positions, and at the areas where the ac- curacy was checked. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 74: Verifying Accuracy

    Hold the pointer to at least three known anatomical landmarks and verify that the posi- tion of the pointer displayed in the image views corresponds with the actual point on the patient’s anatomy. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 75 NOTE: If during visual verification a deviation of more than 3 mm is observed, we rec- ommend that you select Try Again or Details , and/or check the pointer accuracy. If has registration failed, press Try Again to repeat registration. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 76: Detailed Registration Accuracy Information

    For example, the software may “ignore” certain points where accuracy was insufficient. How to Access Detailed Step Information Press Details in the Patient Registration verification dialog (see page 74). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 77 • The deviation from the pointer tip to the point you acquired during registration Acquired point • The deviation from the pointer tip to the point planned in the data set ( Planned point Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 78 . The software opens the previous Patient Registration dialog so that you can review the overall error. To return to the previous Patient Registration dialog without applying any changes, press Cancel Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 79: Surface Matching Registration

    Introduction to Surface Matching Registration page 80 Activating Surface Matching Registration page 82 Softouch Registration page 85 z-touch Registration page 86 Surface Matching Registration Accuracy page 91 Additional Guidelines for z-touch Registration page 99 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 80: Introduction To Surface Matching Registration

    Softouch You can switch between registration modes by pressing either z-touch Softouch in the Patient Registration dialog. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 81 Verify the scannable surface and if necessary, adjust the threshold. Acquire surface matching points using Softouch z-touch If you are performing registration, acquire additional points at the back z-touch of the skull. Verify registration accuracy. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 82: Activating Surface Matching Registration

    Activating Surface Matching Registration Activating Surface Matching Registration Registration Selection How to Activate Figure 22 Steps Press Register in the menu bar. In the Registration Selection dialog, press Surface Matching Registration Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 83 To optimize surface matching results by adjusting threshold values, press page 84 Adjust Threshold To activate registration using z-touch , press z-touch page 86 To activate registration using , press page 91 Softouch Softouch Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 84: Adjusting Threshold Settings

    The software recalculates the three dimensional reconstruction in the Patient Registration dialog. Additional Options Options To optimize values for MR or CT, press Auto To restore settings to those stored the last time you left this dialog, press Reset Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 85: Softouch Registration

    When a sufficient number of points is acquired, is enabled. Proceed Press Proceed to start the surface matching calculation. The calculation may take a few moments. Verify registration accuracy in the dialog that opens (see page 91). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 86: Z-Touch Registration

    • Mouth and jowls: these areas are either not included in the scan or are distorted by the intubation. NOTE: Generally, all (bony) structures with a characteristic surface that does not change during anaesthesia are appropriate for scanning. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 87 However, the further away the face is, the higher the deviation due to the distance between the face and the back of the head. Additional points from the back of the head will reduce this deviation. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 88: Performing Z-Touch Registration

    • Keep the out of the camera field of view as the software automatically Softouch switches to Softouch mode as soon as the Softouch appears in the camera field of view Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 89 NOTE: Hold z-touch perpendicular to scanned surface so that the laser beam meets the skin as a point. Point acquisition is indicated by a “beep” and a progress bar. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 90 Proceed (enabled when sufficient points are acquired) to start the surface matching calculation. The calculation may take a few moments. Verify registration accuracy in the dialog that opens (see page 91). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 91: Surface Matching Registration Accuracy

    Due to error propagation, navigation accuracy may be degraded compared to accuracy achieved at the landmark positions, and at areas where the accuracy was checked. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 92: Verifying Accuracy: Standard Procedure

    93. NOTE: If during visual verification a deviation of more than 3 mm is observed, we recom- mend that you select Modify , and/or check the pointer accuracy. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 93: Verifying Accuracy: Overview Of Advanced Features

    How to Access the Advanced Features Step Press this button in the sagittal view of the accuracy di- Patient Registration alog (see page 92) to display a reliability (color-coded) map in all views. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 94 3D view (page 95). You can press Over- to toggle between the overview and the axial, coronal, and sagittal displays. view Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 95 • Red: > 5.0 mm NOTE: For example, a red point may indicate that you acquired a point on an area of the patient that is not included in the scan. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 96 To open the surface matching registration dialog where you can acquire additional points using e.g., the pointer, press Modify To deactivate the reliability map and return to the first Patient Registration accuracy dialog, press this button. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 97: How To Verify Accuracy Using Advanced Features

    • If the displayed distances are acceptable, continue to step 4. • If the displayed distances indicate unacceptable inaccuracies, you can press Modify and acquire additional points. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 98 • If neither solution is acceptable, you can press Modify and acquire additional points or repeat surface matching registration. Make sure you verify the accuracy of the selected registration solution using the reliability map. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 99: Additional Guidelines For Z-Touch Registration

    Scanning two circles around the patient’s eyes, also including the nose, should result in an accurate registration. Additional points can be acquired using the pointer or the Softouch Point Acquisition using the Patient Position z-touch Scan Regions Pointer or Softouch Can be combined Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 100 Acquire 10-15 additional points using the pointer or . Acquire points in Softouch those areas which are circled around the eye and the crown. Point Acquisition using the Patient Position z-touch Scan Regions Pointer or Softouch Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 101 . Points should be acquired around the eye and the bony part of the nose. Point Acquisition using the Patient Position z-touch Scan Regions Pointer or Softouch Scan the shaved area us- z-touch Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 102: Effects Of Scan Areas On Accuracy

    Shows the accuracy achieved when using these points for surface matching. The lines indicate the accuracy or deviation: each line represents a deviation of 0.5 mm from center circle. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 103: Intraoperative Landmark Registration

    Intraoperative Landmark Registration Intraoperative Landmark Registration Chapter Overview Contents Topics Covered Section Introduction to Intraoperative Landmark Registration page 104 Acquiring and Registering Intraoperative Landmarks page 106 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 104: Introduction To Intraoperative Landmark Registration

    Registration Selection dialog and select Register Intraoperative Landmarks Register the intraoperative landmarks. Verify the registration accuracy. If intraoperative registration is needed, open the Registration Selection dialog and select Acquire Intraoperative Landmarks Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 105: Registration Instruments And Software Guidance

    The software emits a beep each time you register a landmark. Auditory Software Cues If you attempt to register the same landmark more than once, the software emits a lower toned beep and does not re-register the point. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 106: Acquiring And Registering Intraoperative Landmarks

    Acquiring and Registering Intraoperative Landmarks Acquiring Intraoperative Landmarks How to Activate Figure 33 Steps Press in the menu bar. Register In the dialog, press Registration Selection Acquire Intraoperative Landmarks The acquisition dialog opens. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 107 A maximum of seven can be defined. Once at least four landmarks are defined, press Proceed to return to the main screen. NOTE: Pressing Delete removes the most recently acquired landmark. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 108: Registering Intraoperative Landmarks

    How to Activate Registration Figure 35 Steps Press Register in the menu bar. In the Registration Selection dialog, press Register Intraoperative Landmarks (available once you have acquired intraoperative landmarks). The registration dialog opens. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 109 If you delete intraoperative landmarks, you may not be able to re-register the patient if the initial registration is lost (e.g., if a reference array is moved). In this case, navigation cannot be continued. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 110 Acquiring and Registering Intraoperative Landmarks Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 111: Configuring Views

    Configuring Views Configuring Views Chapter Overview Contents Topics Covered Section Navigation Views page 112 View Configuration page 118 Windowing page 127 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 112: Navigation Views

    Navigation Views Navigation Views About the Views Main Screen The navigation screen displays the patient’s anatomical information on the screen in four different views. Figure 37 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 113 Image Labeling Depending on the displayed image, views are labeled with the image orientation: Label Orientation Anterior Posterior Left Right Head Foot Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 114 The display of object contours may be of lower resolution than the underlying scan data. Review the object carefully to make sure it properly represents the area of interest. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 115 When the pointer or navigated instrument is inline with the view (meaning the instrument axis is in the image plane), a prolongation of the instrument is shown. The prolongation is always shown in inline views. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 116 This button is shown in 2D inline and probe’s eye views, and allows you to rotate the view clockwise in order to match the actual patient orienta- tion. NOTE: The availability of this button depends on your system configura- tion. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 117 • If patient data has been loaded from the network, the image file is stored in the directory from which the data was loaded. This is configured by BrainLAB support.

  • Page 118: View Configuration

    Press the eye icon in the upper left view to open the dialog above. Press the desired view. The dialog closes and the view is updated with the select- ed image. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 119 Inline 1 page 120 Probe’s Eye page 120 3D Overview page 121 Microscope page 220 Live Video page 124 Auto Pilot page 125 NOTE: Availability depends on your system configuration and licenses. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 120: Inline And Probe's Eye Views

    Inline I view. The probe’s eye plane contains the instrument tip. Adjusting the In the above views, use the optional flip/rotate arrows buttons to adjust the orientation. Orientation Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 121: 3D View

    NOTE: The navigation system may take longer to update while calculating the 3D view. Inspect 3D Overview after calculation and adapt the threshold (see page 127) if the surface is not represented correctly. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 122: 3D Overview

    Objects, instruments, points, trajectories, etc. are displayed transparently with respect to the 3D surface, but not with regard to other objects, instruments, points, trajectories, etc. Thus objects, instruments, points, trajectories, etc. may cover each other. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 123: Adjusting The Threshold Of 3D Images

    . The software recalculates the three dimensional reconstruction in Close the view. Additional Options Options To optimize values for MR or CT, press Auto To restore settings to those stored the last time you left this dialog, press Reset Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 124: Live Video Views

    Color image injection from external devices may display the objects in a different color as seen on the navigation screen. We rec- ommend that you use context information such as size and position to identify the objects. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 125: Auto Pilot View

    Auto Pilot played when: • The instrument is within 50 mm of the entry point • The angle deviation of the instrument from the trajectory is less than 30° Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 126 NOTE: Once the instrument reaches the target plane, the Auto Pilot display appears red. A warning tone is emitted if the instrument penetrates beyond the target. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 127: Windowing

    If the windowing is set to 0 in MR image sets, the software will automatically adjust it to 30. Transferring Windowing Settings Secondary or inverse windowing cannot be transferred from the planning soft- ware to the navigation software. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 128: Adjusting Windowing

    How to Rename the Image Set Steps (Optional) Press Label Enter a name in the dialog that opens. Press Proceed to confirm the name and return to the windowing dialog. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 129: Calibrating Instruments

    Topics Covered Section Introduction to Calibration page 130 Accessing Calibration page 134 Calibration Using the Reference Array page 138 Calibration Using the ICM4 page 141 Calibration Using the ICM 2.0 page 149 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 130: Introduction To Calibration

    The software can simultaneously track instruments with different-sized arrays attached. If Instruments you introduce an instrument with a new geometry (not previously used in this session), the software opens the calibration dialog. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 131 To verify the accuracy of the instrument calibration during surgery, repeatedly point the calibrated instrument to known anatomical landmarks and verify the position displayed on the screen. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 132: Handling Instrument Adapters

    If the software recognizes that an instrument adapter is too small for an instrument, the di- Calibration alog below is displayed. Figure 48 You can now attach a larger adapter, or change the adapter position on the instrument and press to repeat calibration. Try Again Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 133 Rotating an array and/or a clamp on a pre-calibrated instrument requires a new instrument calibration. Exchanging an instrument tip (e.g., Multiple Tip Pointer tips) requires a new in- strument calibration. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 134: Accessing Calibration

    Carefully read the following sections in the Instrument User Guide - Reference Arrays - Instrument Adapter Kit, StarLink Interface - Skull Reference Set Reference Headband Reference Headband Array - ICM4 - ICM 2.0 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 135: Accessing Calibration In The Tools Dialogs

    Activate calibration and/or verification of instruments to which a StarLink instrument adapter is attached. Calibration/ page 138 Verification You can also load precalibrated geometries, e.g., for Eraser instruments (see page 171). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 136: Loading Precalibrated Geometries And Restoring A Calibration

    Eraser . If more than one precalibrated instrument is available, the button is named Load , and you must select the required instrument in a sepa- rate dialog. Verify the calibration in the verification dialog that opens. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 137 Make sure that you have not exchanged the instrument or repositioned the adapter since the previous calibration. Verify the restored calibration. If the instrument has been exchanged or the adapter moved, do not restore the calibration. Instead perform a new calibration. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 138: Calibration Using The Reference Array

    ICM4 or ICM 2.0 . Reference Array Position Make sure that the reference array position does not change during calibration verification. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 139: Performing Calibration

    After calibrating an instrument using the cone, the plane of the instrument adapter array is orthogonally transferred until it intersects with the instrument tip. Thus, the calibrated instrument trajectory may not correspond to the actual instrument axis. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 140 Select the diameter on the scale. Fine-tune the diameter in 1 mm increments us- ing the buttons. To set the value back to 0, press Reset Press Accept to confirm the value. The software prompts you to verify the calibration. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 141: Calibration Using The Icm4

    Verifying Calibration Each instrument calibration using the ICM4 requires a deviation check of the trajectory, diameter and instrument tip. This will show whether these parame- ters accurately represent the actual instrument. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 142: Calibration And Verification Using Pivot Points

    Try Again Remove from camera field of view. ICM4 Other Options You can define an instrument diameter by pressing Set Diameter in the Verification of Cal- ibration dialog (see page 140). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 143: Calibration And Verification Using Receptacles (Holes)

    Calibrating Instruments Calibration and Verification Using Receptacles (Holes) The Calibration and Verification Dialogs Figure 57 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 144 If the instrument diameter is not the same as that of the selected receptacle, you can adjust this by pressing Set Diameter in the Verification of Calibration dialog (see page 140). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 145: Calibration And Verification Using The V-Inset (Notch)

    To calibrate the tip and the axis, calibration is performed in two steps: • The tip is calibrated in the pivot points • The axis is calibrated in the V-inset The Calibration and Verification Dialogs Figure 58 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 146 Following calibration, remove ICM4 from camera field of view. You can define an instrument diameter by pressing in the Other Options Set Diameter Verification of Cal- ibration dialog (see page 140). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 147: Calibrating Suction Tubes

    Additionally, keep the following in mind: Calibration Tips Make sure that the suction tube tip is perpendicu- lar to the pivot point. Rotate the suction tube in the pivot point without tilting the tip. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 148 Suction Tube Tip Deviation Charr 8 Deviation Charr 10 Pear-shaped (Rev. 1) 1.06 mm 1.29 mm Pear-shaped (Rev. 2) 0.77 mm 1.10 mm Frazier 0.83 mm 1.07 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 149: Calibration Using The Icm 2.0

    2 -30 mm. The 30 mm receptacle can only be used for pointed instruments as it is conically- shaped at the bottom. The ICM 2.0 Figure 59 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 150: Calibration And Verification

    If the instrument diameter is not exact, you can adjust this by pressing in the Other Options Set Diameter Verification of Calibration dialog (see page 140). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 151: General Navigation Functions

    General Navigation Functions Chapter Overview Contents Topics Covered Section Accuracy Checks page 152 Patient Orientation page 155 Measurement Functions page 156 Freeze Mode page 160 Tooltip Offset page 161 Trajectories page 164 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 152: Accuracy Checks

    NOTE: If you point to a marker or a preplanned landmark, the system recognizes the point and displays the deviation from the pointer tip to the marker/landmark. To detect any system malfunctions, you must verify accuracy repeatedly throughout the procedure. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 153 General Navigation Functions Decreased Accuracy Brain shift may cause a discrepancy between preoperative patient data and the actual position. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 154: Verifying The Pointer And Softouch

    Hold instrument tip in reference array cone. The distance between the pointer/ Softouch tip and the cone is displayed in the navigation screen. Do not use an inaccurate pointer or Softouch Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 155: Patient Orientation

    To make sure that the patient orientation was set correctly in the scan protocol, verify that the image labeling (see page 113) matches the actual patient orienta- tion (anterior-posterior, left-right, and head-foot direction). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 156: Measurement Functions

    Measurement Functions Measurement Functions Accessing Measurement Functions How to Access Measurement Step Open the Tools > Measurement dialog. Figure 64 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 157: Displaying A Scale

    (except 3D and video views). When you zoom in and out of views, the scale is updated accordingly. Do not use Display Scale for actual measurement as the displayed structure may not represent the real structure, due to e.g., windowing. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 158: Displaying Distances

    Measurement Functions Displaying Distances Displayed Distances (Examples) Figure 66 Explanation Distance to a point Distance to the default target Distance to the target of a trajectory Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 159 Display Distances Hold the pointer to the first measurement point. Press Freeze Move the pointer to the second measurement point. The software displays the distance between the points in standard 2D views. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 160: Freeze Mode

    Tracking dated (i.e., centered in the navigation views). Using Freeze with If the Eraser function is activated, Freeze mode is not available. Eraser Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 161: Tooltip Offset

    NOTE: Pressing Reset sets the offset back to 0 mm and closes the dialog. Press Close to apply values and return to the navigation screen. The actual offset is shown above the Tooltip buttons. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 162 To virtually extend the instrument tip in increments of 1 mm, press the Tip Extension + button. To virtually retract the instrument tip in increments of 1 mm, press the Tip Extension - button. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 163 The reconstructions and all other views are updated to the virtual tip. Do not use the tip offset function for instruments which have been calibrated us- ing the calibration cone of the reference array or the pivot points of the Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 164: Trajectories

    Tool > Intraop. Trajectory dialog which opens, the point is displayed as a red cross-hair. You can now modify the point using the same options available for modifying trajectories (see page 165). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 165 NOTE: If you defined a target point only, the red cross-hair represents the tip of the instru- ment. Colors of trajectories may change during the transfer from iPlan to the naviga- tion software. Trajectories are always displayed in green in the navigation soft- ware. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 166 To delete the displayed trajectory, press Delete To apply settings, press Close to return to the navigation screen or press Back to return Data > Points Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 167 Trajectories in the via the Trajectory button in the Tools dialog. Tools Dialog Figure 74 NOTE: The Trajectories button is only available if at least one trajectory or target point has been defined. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 168 Trajectories Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 169: Eraser Navigation

    Eraser Navigation Eraser Navigation Chapter Overview Contents Topics Covered Section About Eraser page 170 Instrument Calibration and Verification page 171 Eraser Navigation page 173 Modifying the Eraser Object page 174 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 170: Introduction

    4 mm is used by the software to trace the volume. For instruments with a given diameter, a cylindrical brush is used with the same height and width as the instrument diameter. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 171: Eraser Instruments

    Further calibration by the user is not necessary. To use the Eraser instrument, you must load the calibration and verify its accuracy using an ICM or a reference array. Calibration and Verification Dialogs Figure 75 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 172 Eraser tool upright in the reference array cone and subtract 2.8 mm from the displayed tip deviation. Always load the precalibrated instrument geometry when using the Eraser strument as a manual calibration will not be accurate. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 173: Using Eraser

    ( Eraser overlay enabled ). Once the object is created, press Eraser again to end the session. Eraser Changes dialog opens in which you can modify the object (see page 174). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 174: Modifying The Eraser Object

    The dialog closes and the object is displayed accordingly in the image views. Other Options Options To delete the most recent modifications, press Reject To delete the entire object, press Delete all Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 175 Eraser Navigation Example Eraser Object in Image Views Figure 77 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 176 Using Eraser Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 177: Navigating Alignment Instruments

    Navigating Alignment Instruments Navigating Alignment Instruments Chapter Overview Contents Topics Covered Section VarioGuide page 178 Frameless Biopsy System page 191 Disposable Biopsy Needle Type A page 200 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 178: Varioguide

    184 Verify alignment, and if required, perform further fine adjustments. page 186 Navigate instrument to planned target point: page 187 • General instruments • Disposable Biopsy Needle Type A page 188 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 179: Verifying Instruments

    Troubleshooting If the accuracy is insufficient, make sure that: VarioGuide • The is correctly assembled VarioGuide Verification • The guide disk is properly attached • The VarioGuide array is not bent Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 180 • The tracking array on the needle and the tracking array are visible to the VarioGuide camera • The reflective surfaces are not soiled or damaged • The needle is not bent Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 181: Defining The Initial Position And Performing Rough Adjustments

    Defining the Initial Position and Performing Rough Adjustments Before You Begin Make sure you have defined a trajectory (see page 164). How to Activate VarioGuide Navigation Figure 80 Step Open Tools and press VarioGuide Initial Position dialog opens. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 182 Lock all joints by tightening screws. Press Proceed to continue to coarse adjustment steps. NOTE: It is helpful to have these adjustments set when the device is assembled after ster- ilization. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 183 Lock joint! The software displays minimum instru- ment length required to reach planned tar- get point. Turn central tension handle clockwise to lock it. Press Proceed to continue to the alignment steps. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 184: Aligning The Varioguide To The Planned Trajectory And Verifying Accuracy

    Make sure that the accuracy is sufficient before proceeding. Realigning the VarioGuide If you modify the guide disk, or if you change the instrument diameter, you must realign the VarioGuide to the trajectory. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 185 0°. Adjust until deviation is close to Joint 3 0°. Once all adjustment steps are completed, the Adjustment completed dialog opens in which you can verify the accuracy of the alignment. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 186 . The navigation view opens. • If there is a large deviation in the accuracy, or if you would like to repeat align- ment, press . The dialog opens. Try Again Initial Position Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 187: Navigating The Varioguide With General Instruments

    The soft- VarioGuide ware displays the distance from the bottom of the guide disk (indicated by the pink cross- hair) to the target point. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 188: Preparing The Varioguide For Navigation With The Disposable Biopsy Needle

    Make sure that the needle has been verified (see page 180). Configure navigation screen. In most cases, the Auto Pilot view is useful. NOTE: The Auto Pilot view is available only if a trajectory is planned and dis- played. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 189 , it is important to follow steps 3 and 4. If the tracking array on the needle be- comes hidden from view during navigation, the position of the stopper prevents the needle from penetrating beyond the planned target. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 190 Be aware that when you remove the lock ring a of the guide disk (e.g., to re- move the inserted instrument), the outer disk s will also loosen. Make sure to handle the guide disk components carefully when removing them. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 191: Frameless Biopsy System

    193 Align biopsy tube to planned trajectory (if one has been planned). page 196 Calculate insertion depth of biopsy needle. page 198 Navigate needle to planned target point. page 200 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 192: Verifying Instruments

    The software calculates and displays the trajectory deviation of the biopsy needle based on the coordinates of the tracking array on the needle and the Biopsy Alignment Array Press to return to the dialog. Close Tool Calibration/Verification Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 193 ICM4 and the Biopsy Alignment Array Review the values displayed and decide whether they are acceptable for the cur- rent procedure. Press Close to return to the Tool Calibration/Verification dialog. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 194 Frameless Biopsy System Troubleshooting If the accuracy is insufficient, make sure that: Biopsy Tube • The biopsy tube is correctly assembled Verification • The biopsy tube is properly placed in ICM receptacle Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 195: Aligning The Biopsy Tube And Calculating The Instrument's Insertion Depth

    Configure the navigation screen. In most cases, the Auto Pilot views is useful. NOTE: The Auto Pilot view is available only if a trajectory is planned and displayed. Screenshot Showing Alignment Figure 87 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 196 Verify the adjustment quality by zooming in on each view. The target of the in- tended biopsy must be located in the middle of the virtual biopsy tube. The distance to target is now displayed at the bottom of the navigation views. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 197 NOTE: This now represents distance to target. Verify the adjustment quality by zooming in on each view. The target of the in- tended biopsy must be located in the middle of the virtual biopsy tube. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 198 Measure stopper position on instru- ment using ruler. Secure stopper a on instrument at calculated position. Insert instrument into biopsy tube and navigate instrument to planned target point (see page 200). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 199 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 200: Disposable Biopsy Needle Type A

    Disposable Biopsy Needle is in the camera field of view. It can be tracked again if the Disposable Biopsy Needle is hidden from the camera field of view for at least 2 seconds. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 201 Be aware that the software calculates the distance from the tip of the Disposable Biopsy Needle to the planned target point. However, the biopsy window is not located at the tip of the needle. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 202 (e.g., if needle is bent or not inserted correctly into the guide disk). If this happens, you should verify the accuracy of the biopsy instru- ments as described on page 179. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 203: Microscope Navigation

    Topics Covered Section Introduction to Microscope Navigation page 204 Initializing the Microscope page 205 Verifying the Microscope page 207 Microscope Navigation page 213 Microscope Tools page 216 Microscope Images page 220 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 204: Introduction To Microscope Navigation

    Instrument User Guide ing the microscope features. Workflow Overview Workflow Initialize the microscope. page 205 Verify microscope calibration. page 207 Recalibrate the microscope (optional). page 211 Navigate the microscope. page 213 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 205: Initializing The Microscope

    NOTE: If only one microscope is configured, this dialog is skipped. In the Microscope Detection dialog, select the button for the microscope config- uration to be used. The microscope is now initialized and the Microscope Calibration Verification dialog is displayed. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 206 • Turned on and fully booted • In navigation mode (see documentation from microscope manufacturer) NOTE: If microscope communication cannot be established, it may help to switch the mi- croscope off and on again. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 207: Verifying The Microscope

    Microscope video view (if available, see page 220) Distance from microscope to center of reference array (cone) Video Verification button: Press to toggle between the microscope views and ax- ial, sagittal and coronal views Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 208 NOTE: When using the Olympus microscope, be aware that the orientation of the micro- scope depthview may not be correct, as the OME-9000/OME-8000/OME-7000 observer can be moved in a way so that the view orientation through the microscope changes. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 209: Verifying The Calibration

    HUD calibration. You can verify calibration at any time during navigation. NOTE: BrainLAB provides cross-hair oculars for integrated microscopes. Using the cross-hair aids in the verification and calibration of the microscope. The ocular may be re- placed with a standard, clear one after calibration.
  • Page 210 This value shows the deviation of the current calibration. Verify that the deviation is within an acceptable range. • If accuracy is sufficient, press Next • If accuracy is insufficient, press Recalibrate to open the Microscope Calibra- dialog. tion Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 211: Recalibrating The Microscope

    Before navigating with a microscope, the focal length and axis of the microscope must be properly calibrated. BrainLAB completes a service calibration during installation of the mi- croscope adapter. You can perform a user calibration to compensate for slight calibration inaccuracies that occur over time.
  • Page 212 Always check the microscope accuracy after calibrating by testing if the micro- scope’s focus point is correctly displayed in the patient’s data. This can be done by focusing on a marker sphere or on an anatomical landmark (see page 209). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 213: Microscope Navigation

    Tools > Microscope > Options dialog opens. Navigation Figure 92 Options Press Close to exit this dialog and begin microscope navigation. Press Back to open the Tools > Microscope dialog (see page 216). Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 214: Navigation Views

    The minimum and maximum working area (the focus distance of the microscope) is mea- Working Area sured when the microscope is calibrated for the first time by BrainLAB support. If the microscope moves outside of the calibrated focus range during navigation: •...
  • Page 215 To judge the microscope po- sition via navigation screen and to obtain up-to-date information about overlaid objects, do not modify focus, zoom or microscope position for a few seconds. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 216: Microscope Tools

    206 Options Select microscope navigation features page 217 Calibrate Microscope Recalibrate microscope page 211 Adjust settings for microscope video display Video Configuration (If microscope video is available and calibrat- page 218 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 217: Microscope Options

    NOTE: If the microscope is not focusing, double check that the instrument, the reference array, and the microscope tracking array are in the camera field of view. How to Activate Figure 95 Steps Open Tools > Microscope > Options Press Smart Auto-Focus Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 218: Configuring Microscope Video

    During each intervention, make sure that the video is connected to the same in- put selected during calibration. Using a different input may result in an incor- rect calibration. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 219 Video Display The video display may be delayed if the system is being used to full capacity. We recommend that the microscope video image be displayed separately on an additional monitor. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 220: Microscope Images

    How to Display the Microscope View Steps Press the eye icon. Select the tab. Other Views Press Microscope The dialog closes and the view is updated with the microscope view. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 221 Microscope Navigation Displayed Microscope Video View Figure 97 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 222 Injected 3D objects serve as an overview, but do not relate exactly to the under- lying patient structure. As injected objects are based on the pre-operative image set, the current posi- tion of the real object may differ due to e.g., brain shift or resection. Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...

  • Page 223: Index

    ..................non-BrainLAB instruments eye icon ..............overview of calibration methods assigning views ............. restoring ........set instrument diameter ..........using ICM 2.0 ..........using ICM4 Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 224 Disposable Registration Marker, MR, CT, OR verification overview ..............Frameless Biopsy System verification using landmarks .............. Instrument Calibration Matrix verification using the cone ................marker sphere geometry Video Verification Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 225 ..................register button Sound Output ..............register intraoperative landmarks standard registration ........... registration start software ..............acquire intraoperative landmarks Starting Navigation ..................camera positioning Sterilization Trays Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 226 Golden Rules Try Again button ............. guidelines ......occipital/suboccipital approach ......... suitable scan regions ......temporal/pterional approach z-touch registration accuracy ............. user guides ........... scan areas user interface ..........main screen Software User Guide Rev. 1.0 Kolibri cranial/ENT Ver. 2.7...
  • Page 228 Art-No. 60903-58EN...

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