Procurement of a mobile surgical neuronavigation system

Procurement of cranial planning and navigation consisting of the Curve navigation system, a virtual planning server, a VarioGuide, and a microscope connection.

Knappschaft Kliniken Bottrop GmbH, Osterfelder Str. 157, 46242 Bottrop (hereinafter "KKB"), as an acute hospital for general care with 12 specialist clinics and almost 1,200 employees, has 372 beds and treats around 16,000 inpatients annually. KKB is also a teaching hospital of the University of Duisburg-Essen. In the Department of Neurosurgery at KKB, the entire spectrum of operative neurosurgery from head to spine, intensive neurosurgical treatment, and subsequent neurorehabilitation referral is covered in the neurological-neurosurgical center of excellence. KKB intends to procure a neuronavigation system. The neuronavigation system to be procured is needed for the resection of cranial and spinal tumors and is to be used for this purpose, as well as for the implantation of spinal screws and rods and for navigated transcranial magnetic stimulation (nTMS). nTMS is used, among other things, in pain therapy and, especially considering the neurocenter and the Department of Neurology, can represent a further building block for the treatment of movement disorders. It is intended that the neuronavigation system will complement the modern operating microscope, intraoperative electrophysiology, intraoperative ultrasound, the use of continuous ultrasound aspirator/Sonoped, and fluorescence in tumor surgery and vascular neurosurgery as the most modern equipment in a neurosurgical operating room. The neuronavigation should also be capable of easily realizing stereotaxy/STX in the future. This is intended, on the one hand, to avoid personnel and time-intensive intermediate transports out of the operating room and, on the other hand, to significantly simplify the calculation of STX coordinates in order to accurately reach the area to be biopsied in the brain. Likewise, the software should be comprehensive for planning, marking the tumor volume, tractography, and fusion of different image data. The neuronavigation system to be procured is not only to be used in the Department of Neurosurgery but also in joint simultaneous procedures with the Department of Trauma Surgery. The Department of Trauma Surgery requires the neuronavigation system for the safe implantation of foreign material in the spine, in order to avoid misplacement of implants in the spinal canal/risk of cross-section and misplacement in the large prevertebral blood vessels/enormous blood loss. The neuronavigation system must be compatible with various implant manufacturers and not just usable with one manufacturer. Another area of application for the neuronavigation system to be procured is the Department of Vascular Surgery, where it leads to a significant reduction in radiation exposure when treating patients with peripheral arterial occlusive disease (PAOD). The new neuronavigation system should offer the possibility to expand the basic navigation with special functions via additional modules. The neuronavigation system must meet the following requirements: - Fully automated segmentation of CT, MRI, and XT datasets and distortion correction for the fusion of 3D data with 2D angiographies, - Possibility of automatic feasibility analysis of stereotactic radiosurgical/radiotherapeutic planning for remaining tumor volume, - Digital integration of ultrasound navigation systems and interpretation of ultrasound data in relation to existing CT and MRI data, - ROI-based tracking capability with semi-automatic object segmentation or automatic anatomical segmentation, - Possibility to project planned structures as semi-transparent objects into the anatomical context on the navigation screen with microscopes from Zeiss and Leica, - Possibility of image fusion as augmented reality in conjunction with the microscope and VR goggles, - Use of manually and pre-calibrated instruments, including third-party instruments, for anatomical alignment of the system using tractors provided by the navigation system, - Simple connection of STX to the navigation or corresponding realization, so that additional frame-based systems can be dispensed with, - Software of sufficient scope for planning, marking tumor volume, tractography, and fusion of different image data, - Possibility of navigating implants from common manufacturers of consumables, i.e., in detail, navigability of cannulable screws from any manufacturer, to perform complex spinal surgery procedures in neurosurgery and also trauma surgery, - Possibility of nTMS on/with the navigation, - Usability of the system also in the Department of Vascular Surgery to enable radiation reduction in vascular surgery procedures such as PAOD, - Possibility to access updated additional modules for outdated systems and then purchase or install them. Based on market analysis and the pre-tender market inquiry according to § 28 VGV, the requirements can only be met by the Brainlab system.