A remote control for intraoperative ultrasound--is it really necessary?

A remote control, which can be used to manipulate the scanner functions remotely from within the sterile field, is designed to save time during IOUS. This study was designed to evaluate whether the time saved by using a remote control should be a decisive factor in buying a special system.

During 50 intracranial operations, the temporary arrest of the operative procedure caused by the use of ultrasound was measured. In 25 arbitrarily chosen operations, the remote control was draped and used (group 1); in the other group (group 2), it was not used. In addition, we analyzed the use of vascular duplex sonography in 12 of the operations with remote control (group 1a) and 14 of the operations without remote control (group 2a).

The average time spent for ultrasound use including draping was 390 seconds in group 1, compared to 388 seconds in group 2 (without remote control). During examinations including duplex sonography, the average time spent for IOUS including draping was 464 seconds for group 1a and 466 seconds for group 2a.

Based on results, the neurosurgeon does not save much time by using a remote control. The time used for draping the additional remote control is equal to the length of time that is saved. However, the surgeon's frustration in attempting to instruct a layperson to operate the ultrasound keyboard and its impact on the operative procedure cannot be measured.