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The InstaTrak 3000 System is intended as an aid to the surgeon for precisely locating anatomical structures anywhere on the human body during either open or percutaneous procedures. It is indicated for any medical condition that may benefit from the use of stereotactic surgery and which provides a reference to rigid anatomical structures such as sinus, skull, cranial, a long bone or vertebra, visible on medical images such as CT, MR, or Xray.

The InstaTrak 3000 System is an image guidance system indicated for use during sinus, skull base, cranial and axial skeletal procedures. The InstaTrak 3000 with FluoroTrak is similar to the InstaTrak 3000 System cleared under K983529. The changes to the system include software enhancements and the addition of a calibration fixture. Using the InstaTrak 3000, the surgeon can readily identify the immediate location and position of the surgical instrument during the indicated procedure. The InstaTrak 3000 assists the surgeon in avoiding critical nerves and other anatomical structures. The InstaTrak 3000 offers multiple modes of operation that includes sinus, skull base, cranial, axial skeletal, to the user based on the indications the user desires. Software is available to the user for using any one, two, or all three of the operational modes. A selection of the operational modes is made by the user prior to the procedure depending needs of the user. The original InstaTrak 3000 System allows the user to view the reconstructed 2D images of the patient's anatomy in response to the mouse or the tracked surgical instrument. Alignment of the patient and images is accomplished through the registration process. In all types of surgery the goal is the same, to indicate to the surgeon based on the pre-operative medical images, where the position of a tracked surgical tool is with regard to the patient's anatomy. The InstaTrak 3000 with FluoroTrak is based on the same hardware and software used in the original InstaTrak System and provides all of the above features. It utilizes the same clinically proven electromagnetic tracking technology as its predecessor.

The aspirators and pointers are accessories of the previously cleared InstaTrak 3000 System, (K983529) and therefore have the same intended use. The InstaTrak 3000 System is intended as an aid to the surgeon for precisely locating anatomical structures anywhere on the human body during either open or percutaneous procedures. It is indicated for any medical condition that may benefit from the use of stereotactic surgery and which provides a reference to rigid anatomical structures such as sinus, skull, cranial, a long bone or vertebra, visible on medical images such as CT or MR.

The aspirators and pointers described above are aspiration and/or localization devices supplied as accessories with the InstaTrak 3000 System. The aspirators and pointers have the same principle of operation, as those accessories described in the predicates, K960330, K981998, K982994, and K983529. Other than the non-sterile reusable labeling and a color change to a non-patient contact portion of the instrument the devices are the same as the predicate.

The InstaTrak 3000 System is intended as an aid to the surgeon for precisely locating anatomical structures anywhere on the human body during either open or percutaneous procedures. It is indicated for any medical condition that may benefit from the use of stereotactic surgery and which provides a reference to rigid anatomical structures such as sinus, skull, cranial, a long bone or vertebra, visible on medical images such as CT or MR.

The InstaTrak System is an image guidance system indicated for use during sinus, skull base, cranial and axial skeletal procedures. The InstaTrak 3000 is essentially identical to the InstaTrak System cleared under K960330 and the Pediatric InstaTrak System cleared under K981998 which are both indicated for use during sinus surgery. The changes to the system include a computer upgrade, software enhancements, additional indications and the addition of several components. Using the InstaTrak 3000, the surgeon can readily identify the immediate location and position of the surgical instrument during the indicated procedure. The InstaTrak 3000 assists the surgeon in avoiding critical nerves and other anatomical structures. The InstaTrak 3000 offers multiple modes of operation that includes sinus, skull base or axial skeletal, to the user based on the indications the user desires. Software is available to the user for using any one, two, or all three of the operational modes. A selection of the operational modes is made by the user prior to the procedure depending needs of the user. The original InstaTrak System allows the user to view the reconstructed 2D images of the patient's anatomy in response to the mouse or the tracked surgical instrument. Alignment of the patient and medical images is accomplished through either an automatic or fiducial registration. The indications for use include sinus cleared under K960330 and pediatric sinus surgery (K981998). In all types of surgery the goal is the same, to indicate to the surgeon based on the pre-operative medical images, where the position of a tracked surgical tool is with regard to the patient's anatomy. The InstaTrak 3000 is based on the same hardware and software used in the original InstaTrak System and provides all of the above features. It utilizes the same clinically proven electromagnetic tracking technology as its predecessor. A newer version of a Sun computer has been substituted to provide 3D display capability which includes 3D models and planar images on top of 3D models, oblique and trajectory matching views. Additionally, a surgical planning capability has been added. This allows the surgeon to plan a trajectory prior to surgery and to observe the pre-surgical track in relation to the actual track during the surgical procedure. A new registration technique has been added whereby the surface of the anatomy can be registered to. New instruments have been added to which tracking sensors have been built in or may be attached. These, along with the surface registration and the new displays allow the system to be used in the proposed indications encompassing axial skeletal, and cranial surgery, in addition to the cleared and pending indications.

The Skull Based InstaTrak System is intended for image guided assistance during skull base surgical procedures. It is intended to be used during skull base surgery involving procedures on the base of the brain (junction of the face and neurocranium).

The InstaTrak System is an image guidance system indicated for use during skull base procedures. The Skull Base InstaTrak System is identical in principles of operation to the InstaTrak System cleared under K960330 and the Pediatric InstaTrak System cleared under K981998, which are indicated for use during nasal surgery. Using the Skull Base InstaTrak System, the surgeon can readily identify the immediate location and position of the surgical instrument during skull base procedures. The Skull Base InstaTrak System assists the surgeon in avoiding critical nerves and other anatomical structures. The Skull Base InstaTrak System includes several new components that were not included in K960330 or K981998, such as a head frame, transmitter arm, extended straight sterile pointer, mouth gag, pharyngeal retractor and nasal speculum. The remainder of the components used in the Skull Base System are identical to those described in the original submission. The additional components do not affect the overall operation of the system as the principles of operation are identical to that described in K960330. Like that system, the Skull Base InstaTrak System is an image guided surgery system that employs a computer with a top mounted swiveling monitor, software and an electromagnetic tracking system. The System uses a Sun SPARC STATION™. The System's proprietary software builds a CT model by taking axial CT images and reconstructing the coronal and sagittal views. The electromagnetic tracking system correlates the movement of surgical instruments to the CT model. The tip of the instrument is displayed as a set of cross hairs in the axial, coronal, and sagittal planes on the InstaTrak System monitor. With the InstaTrak System, CT images are used to assist the surgeon in guiding the position of the instrument during skull base surgery. The Skull Base and InstaTrak Systems allow pre-operative viewing of the patients' CT images, contextual visualization of the pathology, intra-operative localization, screen display outputs for video recording and positional guidance. The system is operated by acquiring an axial CT scan while the patient wears the InstaTrak System headset and associated instruments. The axial images are then transferred via a network connection or cartridge to the InstaTrak System. The Headset position which stays fixed relative to the patients' anatomy, is automatically identified in the CT images by an image processing algorithm. Coronal and sagittal images are reconstructed and along with the Axial images, provide the CT model that will be used as a road map in surgery.

The Pediatric InstaTrak System is an image guided device for use during endoscopic nasal surgery. It is intended to be used during the treatment of acute and chronic sinusitis, endoscopic dacryocystorhinostomy, optic nerve and orbital decompression, the removal of polyps, the biopsy and removal of tumors, and the repair of CSF leaks, pituitary disorder and encephalocele. The Pediatric InstaTrak System is intended for image guided assistance during nasal surgery in pediatric patients. It is intended to be used during the treatment of acute and chronic sinusitis, endoscopic dacryocystorhinostomy, optic nerve and orbital decompression, the removal of polyps, the biopsy and removal of tumors, and the repair of CSF leaks, pituitary disorder and encephalocele.

The InstaTrak System intended for pediatrics is identical to the InstaTrak System intended for adults with the exception of a slight modification to the head set component. The headset assembly, verification pad, and aspirator components have been modified for the Pediatric InstaTrak System. The dimensions of these components of the InstaTrak System have been modified to accommodate the smaller head size of pediatric patients. As described in the original submission, the headset is a single use disposable device made of acetal plastic. The headset is held in place on the patient by spring tension at the three points of contact, the external ear canals, and the bridge of the nose. The headset serves as a foundation for anchoring the electromagnetic transmitter in a fixed location with respect to the patients head to compensate for patient motion during the surgical procedure. The transmitter is attached to the headset prior to surgery by a rotating toggle that is inserted through a slot in the middle of the rectangular section. The headset allow s the device to maintain its registration therefore avoiding the need for re-registration during the surgical procedure. It also continues to perform accurately even while the patient's head is moving during the surgical procedure. The only change between the Pediatric InstaTrak System and the Adult InstaTrak System is a minor change in dimensions of the headset, straight aspirator and verification pad to accommodate the smaller head size of pediatric patients. This is an insignificant modification not affecting safety or effectiveness of the device. The headset is first worn by the patient during the CT scan and is removed immediately after the scan. Prior to surgery, the transmitter is attached to the headset and the headset is again placed on the patient. This avoids the problem of adhesive based fiducials which requires the CT scan do be done very near the time of surgery to avoid displacement or loss of the markets. The modifications to the headset dimensions do not affect safety or effectiveness of the device since the intended use and placement are identical to that summarized above and described in more detail in K960330. The Pediatric InstaTrak System is identical in technological characteristics to the Adult InstaTrak System except for the size of the headset. The Pediatric InstaTrak System and the Viewing Wand are similar in that they both use an articulated mechanical arm. The proposed Pediatric InstaTrak System and the predicate devices are similar in intended use in that they are all intraoperative imageguidance systems. The Viewing Wand links a positioning probe to an image display with a patients CT or MRI image data. The Pediatric InstaTrak System, the Adult InstaTrak System and the Viewing Wand all use a computer, monitor and hard disk storage system. Both the pediatric and adult InstaTrak Systems have fewer indications/features, using only CT images and fewer screen image displays than the predicate Viewing Wand.

Intranasal or sinuses Acute and chronic sinusitis, endoscopic dacryocystorhinostomy, optic nerve and orbital decompression, the removal of polyps, the biopsy and removal of tumors, and the repair of CSF leaks, pituitary disorder, and encephalocele

The device consists of a wheeled cabinet enclosure with a 20-inch color monitor mounted on the top. Mounted within the cabinet is a computer and a spacial tracking device. The electromagnetic, six-degree-of-freedom tracking device is linked to the computer, which provides the monitor with a display of the patient's CT image data and superimposed crosshairs, indicating the position of the tip of the surgical instrument used with the device. The device is controlled via software.