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Related Experiment Video

Updated: Jun 26, 2026

Protocol for the Evaluation of MRI Artifacts Caused by Metal Implants to Assess the Suitability of Implants and the Vulnerability of Pulse Sequences
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Intraoperative Metal Detection vs. Preoperative computed tomography for Combat-related Shrapnel Localization: A

Erez Hassidov1, Dan Paz2, Felicity Kassis3

  • 1Department of Otolaryngology-Head and Neck Surgery, Galilee Medical Center, Nahariya, Israel, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.

The Israel Medical Association Journal : IMAJ
|June 25, 2026
PubMed
Summary

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Intraoperative metal detectors aid in locating shrapnel in combat neck injuries, enabling smaller incisions and improved precision. While dissection time may increase, surgeon stress and task complexity are reduced, showing promise for trauma care.

Area of Science:

  • Trauma Surgery
  • Surgical Technology
  • Medical Device Evaluation

Background:

  • Combat-related penetrating neck injuries (PNI) pose surgical challenges, requiring precise metallic fragment removal.
  • Computed tomography (CT) is standard, but intraoperative tools may enhance accuracy and efficiency.

Purpose of the Study:

  • To evaluate the feasibility of using intraoperative metal detectors versus a CT-guided approach for metallic fragment extraction in simulated combat neck injuries.

Main Methods:

  • Cadaver heads with implanted metallic fragments underwent CT scans.
  • Two extraction methods were compared: intraoperative metal detector assistance and CT-guided primary approach.
  • Key metrics included incision length, dissection time, and surgeon workload (using the Surgery Task Load Index).

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Main Results:

  • Metal detector use led to significantly smaller initial incisions (3.50 cm vs. 4.87 cm) and extensions (0.33 cm vs. 0.67 cm).
  • Dissection time was longer with metal detectors (15:00 vs. 12:20 minutes), attributed to learning curves.
  • Surgeons reported lower stress (2.25 vs. 4.5) and complexity (4.0 vs. 4.5) with metal detectors, despite increased mental demand.

Conclusions:

  • Intraoperative metal detection is a promising adjunctive tool for shrapnel localization in combat PNI.
  • This technology can minimize incisions and enhance surgical precision.
  • Further clinical adaptation is needed, but it may improve outcomes in military and civilian trauma.