Novosti

 

GODIŠNJA NAGRADA EUROPEAN MEDICAL ASSOCIATION (EMA) I EUROPEAN BUSSINESS ASSEMBLY (EBA), "ROSE OF PARACELSUS ANNUAL AWARD" ZA "BEST MEDICAL PRACTICE" 2017-2018.

European Medical Association (EMA) i European Bussiness Assembly (EBA) su dodijelile prestižnu godišnju nagradu izvrsnosti "Rose of Paracelsus Award" za najboljeg liječnika i najbollju medicinksu praksu za razdoblje od 2017-2018 godine. Nagrada je uručena sveučilišnom profesoru Ivici Klapanu i Poliklinici Klapan Medical Group, Zagreb, Hrvatska, EU, u Londonu, Velika Britanija, dana 22. studenog 2017. godine.

* EUROPEAN RHINOLOGIC SOCIETY (ERS )-SOCIETY INFORMATION (2014)
* EUROPSKO RINOLOŠKO DRUŠTVO (ERS)-ERS INFORMACIJE (2014)
(www.europeanrhinologicsociety.org/society_information.php) - "Profesor Ivica Klapan, Hrvatska, EU, dao je značajan doprinos razvoju navigacijske kirurgije nosa i sinusa i kompjutorom asistirane kirurgije nosa i sinusa"

* PRIZNANJE ZA IZVRSNOST - ODABRALI PACIJENTI (2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023, 2024). Nakon analize nekoliko desetaka tisuća ocjena i komentara, portal www.najdoktor.com je objavio popis liječnika i stomatologa koje su pacijenti, posjetitelji www stranica ovog portala, preporučili i najviše ocijenili. Na popis su uvršteni liječnici i somatolozi koji imaju prosječnu ocjenu najmanje 4,9 ili veću, na skali od 1-5, te koji imaju najmanje 10 ocjena pacijenata, te pretežno pozitivne i konstruktivne komentare. "Sukladno postavljenim kriterijima, provedenoj analizi ocjena i komentara o svim doktorima (liječnicima) u Republici Hrvatskoj, koji se nalaze na portalu www.najdoktor.com, prof.dr.sc. Ivica Klapan, dr. med., je izabran za jednog od najboljih doktora prema izboru pacijenata, a ujedno i kao najbolji otorinolaringolog-kirurg glave i vrata u 2014., 2015., 2016., 2017., 2018., 2019., 2020., 2021., 2022.,  2023., i 2024. godini. Lista svih izabranih doktora može se vidjeti na: http://najdoktor.com/najbolji-lijecnici-po-preporukama-pacijenata/a223#&panel1-2"


I. PREDAVANJA (2010-2013)

I. I. 1. CROATIAN RHINOLOGIC CONGRESS, ZAGREB, HRVATSKA (veljača, 2010.)
OKRUGLI STOL (Prof. Klapan / pozvani predavač/tajnik kongresa/voditelj): Computer Assisted Surgery (CAS)

SAŽETAK:  What is the future of in minimally invasive surgery in Rhinology? 

The navigation-Leap Motion-virtual endoscopy and virtual surgery suggests that real and virtual objects definitely need to be integrated by use of real 'in the air' control with simulation of virtual activities that requires real-time visualization of 3D-virtual endoscopy motions, following the action of the surgeon that may be moving in the virtual reality area. It is achievable with simple hand gestures of the surgeon, which do not differ in any way from all other natural everyday hand or body movements. In this way, the surgeon can predict the course of the surgery. He 'travels' through the virtual space, 'plays' without additional body, head and/or hand gesture changes. Simply, solely with his gaze, the surgeon coordinates his right hand movements, thus enabling, with contact free commands, the course of their preference or needs through the world of 3D-model, virtual endoscopy or virtual surgery, without stopping the endoscopic procedure in process (the endoscope is held by the left hand in the real surgery field). With this, all assumptions that the surgeon/tele surgeon is positioned in this virtual world which they entirely control but which realistically does not exist are achieved. Literatura: Klapan I, et all. Front Otolaryngol Front Otolaryngol Head Neck Surg, 2017; 1(1): 1-7. ; Klapan I, et all.  J Otol Rhinol. 2017; 1(1): 1-7.


I.II. 23. EUROPSKI RINOLOŠKI KONGRES I 29. MEĐUNARODNI SIMPOZIJ O UPALAMA I RINO-ALERGIJI, Ženeva, Švicarska (lipanj, 2010) (Prof. Klapan/faculty/pozvani predavač))
23. Congress of the European Rhinologic Society, and the 29th International Symposium on Infection and Allergy of the Nose (ERS & ISIAN)

PREDAVANJE: Application of advanced virtual reality and 3D computer assisted technologies in rhinology: CAS and Tele-CAS

SAŽETAK: Objectives: 3D image analysis and processing, tissue modelling, virtual endoscopy and surgery (VE, VS), 3D-computer assisted surgery (3D-CAS), as well as tele-3D-CAS, represent a basis for various realistic simulations in medicine, and can definitely create an impression of immersion of a physician in a non-existing virtual environment.  In rhinology, such an revolutionary approach is of paramount importance for the surgeon because of the proximity of intracranial structures and limited operative field layout hampering spatial orientation during the “standard” operative procedure. The possibility of exact preoperative, non-invasive visualization of the spatial relationships of anatomic and pathologic structures, including extremely fragile ones, size and extent of pathologic process, and of precisely predicting the course of surgical procedure, allows the surgeon to achieve considerable advantage in the preoperative examination of the patient and to reduce the risk of intraoperative complications, all this by use different VR methods. Methods: From the very beginning of our 3D-CAS and tele-3D-CA-surgeries, the modeling was done by use of the VolVis, Volpack/Vprender, GL Ware programs on a DEC Station 3100 computer . With the advent of 3D Viewnix V1.0 software, we started using this program, and then 3D Viewnix V1.1 system, AnalyzeAVW system, T-Vox system and OmniPro 2 system on Silicon Graphics O2, Origin200 and Origin2000 computers. Our team used several standards to encode live video signals in telesurgery, such as M-JPEG, MPEG1, MPEG2 and MPEG4. For conferencing/consultation cameras used between two or more connected sites during the surgery, we used JPEG and MPEG1 stream with audio. ORs were connected using several computer network technologies with different bandwidths, from T1, E1 and multiple E1 to ATM-OC3 (from 1Mb/s to 155Mb/s). For computer communications using X-protocol for image/3D-models manipulations, we needed an additional 4Mb/s of bandwidth, instead of the 1Mb/s when we used our own communication tools for the transfer of surgical instrument movements. Discussion: The real-time requirement means that the simulation must be able to follow the actions of the user that may be moving in the virtual environment. The computer system must also store in its memory a 3D model of the virtual environment (3D-CAS models). In that case a real-time virtual reality (VR) system will update the 3D graphical visualization as the user moves, so that up-to-date visualization is always shown on the computer screen. Upon the completion of the CAS and/or tele-CAS-operation, the surgeon compares the preoperative and postoperative images and models of the operative field, and studies video records of the procedure itself. In otorhinolaryngology, especially in rhinology, research in the area of 2D and 3D image analysis, visualization, tissue modelling, and human-machine interfaces provides scientific expertise necessary for developing successful VR applications. The basic requirement in rhinology, resulting from the above mentioned needs refers to the use of a computer system for visualization of anatomic 3D-structures and integral operative field to be operated on. To understand the idea of 3D-CAS/VR it is necessary to recognize that the perception of surrounding world created in our brain is based on information coming from the human senses and with the help of a knowledge that is stored in our brain. The usual definition says that the impression of being present in a virtual environment, such as virtual endoscopy (VE) of the patient’s head, that does not exist in reality, is called VR. The user/physician, has impression of presence in the virtual world and can navigate through it and manipulate virtual objects. A 3D-CAS/VR system may be designed in such a way that the physician, is completely immersed in the virtual environment . Conclusions: VR applications as well as 3D reconstruction of anatomic units becomes a routine preoperative procedure, as we already shown in our surgical activities in the last two decades (our first CAS/May 1994, tele-3D-CAS/October 1998), providing a highly useful and informative visualization of the regions of interest, thus bringing advancement in defining the geometric information on anatomical contours of 3D-human head-models by the transfer of so-called “image pixels” to “contour pixels”. The possibility of data analysis and storage in the 3D form and development of 3D centers at clinical institutions should provide a new quality in proper training of future surgeons in CAS as well as tele-CAS activities (www.mef.hr/MODERNRHINOLOGY and www.poliklinika-klapan.com).  Literatura: Klapan I, et al. (2002) Am J Otolaryngol, 23(1):27-34.; Klapan I, et al.  (2002) Otolaryngology Head Neck Surg, 127:549-557.; Klapan I, et al. (2006) Ear Nose Throat J, 85(5):318-321.; Klapan I, et al. (2008) Coll Antropol, 32(1):217-219.


I. III. 2. CROATIAN RHINOLOGIC CONGRESS, ZAGREB, HRVATSKA (veljača, 2012.)
OKRUGLI STOL (Prof. Klapan / pozvani predavač/tajnik kongresa/voditelj): 3D-Navigation-Compuiter Assisted Surgery in Rhinology (3D-navigation-CAS)

PREDAVANJE:  Do we believe that computer integrated surgery and virtual reality (VR) in rhinology provide better interactive VE-navigation using augmented reality and 3D-operating planning system?

SAŽETAK: 3D image analysis and processing, tissue modelling, virtual endoscopy and surgery, 3D-CAS, as well as tele-3D-CAS, represent a basis for various realistic simulations in medicine, and can definitely create an impression of immersion of a physician in a non-existing virtual environment. The possibility of exact preoperative, non-invasive visualization of the spatial relationships of anatomic and pathologic structures, size and extent of pathologic process, etc., allows the surgeon to achieve considerable advantage in the preoperative examination of the patient and to reduce the risk of intraoperative complications, all this by use different VR methods. In rhinology, research in the area of 2D and 3D image analysis, visualization, tissue modelling, and human-machine interfaces provides expertise necessary for developing successful VR applications. To understand the idea of 3D-CAS/VR it is necessary to recognize that the perception of surrounding world created in our brain is based on information coming from the human senses, such as i.e. virtual endoscopy (VE) of the patient’s head, that does not exist in reality (called VR). VR applications as well as 3D reconstruction of anatomic units becomes a routine preoperative procedure, as we already shown in our surgical activities in the last two decades (our first CAS/June 1994, tele-3D-CAS/October 1998), providing a highly useful and informative visualization of the regions of interest, thus bringing advancement in defining the geometric information on anatomical contours of 3D-human head-models by the transfer of so-called “image pixels” to “contour pixels” (www.poliklinika-klapan.com).  Literatura: Klapan I, et al. (2002) Am J Otolaryngol, 23(1):27-34.; (2002) Otolaryngology Head Neck Surg, 127:549-557.; (2006) Ear Nose Throat J, 85(5):318-321.; (2008) Coll Antropol, 32(1):217-219. ; (2011) Virtual Reality in Medicine, ISBN 978-953-307-518-1,  Intech, 303-336.


I.IV. 24. EUROPSKI RINOLOŠKI KONGRES I 30. MEĐUNARODNI SIMPOZIJ O UPALAMA I RINO-ALERGIJI, TOULOUSE, FRANCUSKA (lipanj, 2012). 24th European Rhino Congress (ERS & ISIAN) (Prof. Klapan/faculty/invited speaker/predsjednik ERS simpozija)

PREDAVANJE: Virtual reality (VR) and computer integrated surgery in rhinology

SAŽETAK:  3D image analysis and processing, tissue modelling, virtual endoscopy and surgery, 3D-CAS, as well as tele-3D-CAS, represent a basis for various realistic simulations in medicine, and can definitely create an impression of immersion of a physician in a non-existing virtual environment. The possibility of exact preoperative, non-invasive visualization of the spatial relationships of anatomic and pathologic structures, size and extent of pathologic process, etc., allows the surgeon to achieve considerable advantage in the preoperative examination of the patient and to reduce the risk of intraoperative complications, all this by use different VR methods. In rhinology, research in the area of 2D and 3D image analysis, visualization, tissue modelling, and human-machine interfaces provides expertise necessary for developing successful VR applications. To understand the idea of 3D-CAS/VR it is necessary to recognize that the perception of surrounding world created in our brain is based on information coming from the human senses, such as i.e. virtual endoscopy (VE) of the patient’s head, that does not exist in reality (called VR). VR applications as well as 3D reconstruction of anatomic units becomes a routine preoperative procedure, as we already shown in our surgical activities in the last two decades (our first CAS/June 1994, tele-3D-CAS/October 1998), providing a highly useful and informative visualization of the regions of interest, thus bringing advancement in defining the geometric information on anatomical contours of 3D-human head-models by the transfer of so-called “image pixels” to “contour pixels” (www.poliklinika-klapan.com).  Literatura: Klapan I, et al. ; (2002) Am J Otolaryngol, 23(1):27-34.; (2002) Otolaryngology Head Neck Surg, 127:549-557.; (2006) Ear Nose Throat J, 85(5):318-321.; (2008) Coll Antropol, 32(1):217-219. ; (2011) Virtual Reality in Medicine, ISBN 978-953-307-518-1,  Intech, 303-336.


I.V. 2. KONGRES EUROPSKE AKADEMIJE ZA OTORINOLARINGOLOGIJU-KIRURGIJU GLAVE I VRATA/ ORL, NICA, FRANCUSKA (travanj, 2013)
2nd European Academy of Otorhinolaryngology-Head and Neck Surgery and 2nd CE-ORL (Prof. Klapan/faculty/invited speaker/voditelj instrukcijskog kirurškog tečaja)
INSTRUKCIJSKI KIRURŠKI TEČAJ (Prof. Klapan / voditelj): Computer integrated surgery (CIS) with application of advanced virtual reality (VR) techniques in interactive virtual rhinoendoscopy/virtual surgery (VS)/navigation operation systems (CAS)
FORUM (Prof. Klapan / pozvani predavač/panelist): ROBOTIC SURGERY

FORUM SYMPOSIUM - ROBOTIC

2nd EAORL-HNS, 2nd CE-ORL, 27-30 April 2013, Nice-Acropolis

Invited speakers:  O. Sterkers (F), I. Klapan (CRO), M.D. Caversaccio (CH), O. Madjani (D),  T. Klenzner (D), Y. N'gyjen (F), S. Verges (F), Ph.C. Lombard (F)

Instructional Course  RHINOLOGY 2 N°3

2nd EAORL-HNS, 2nd CE-ORL, 27-30 April 2013, Nice-Acropolis

RHINOLOGY - INSTRUCTIONAL COURSE; Chairperson, Professor Ivica Klapan, MD PhD 

PREDAVANJE:  Computer integrated surgery with application of advanced virtual reality (VR) techniques in interactive virtual rhino-endoscopy/virtual surgery (VS) navigation operation systems

SAŽETAK: The need of a more precise identification of the pathologic process extent as well as of the fine elements of intracranial anatomic features is often experienced in diagnostic process and during many operations in the nose, sinus, orbit and base of the skull region. In two case reports, the methods used in diagnostic work-up and surgical therapy in the nose and paranasal sinus region are described. Besides baseline x-ray, multislice computed tomography and magnetic resonance imaging scans, the techniques of operative field per viam imaging by use of rapid prototyping model, virtual endoscopy, and patient head 3D-imaging (3D-Doctor) were employed with differential coloration of all substantial head tissues (different tissues visualized in different colors), their anatomic inter-relations, and the extent of pathologic tissue within the operative field. This approach has not yet been used as a standard preoperative or intraoperative procedure in otorhinolaryngology. In this way, we tried to understand the new, visualized 'world of anatomic relations within the patient's head' by creating an impression of perception (virtual perception) of the given position of all elements in a particular anatomic region of the head, which does not exist in the real world (virtual world). This approach was aimed at upgrading diagnostic work-up and surgical therapy by ensuring a faster, safer and above all simpler operative procedure. In conclusion, every ENT specialist, i.e. any member of our surgical team, is able to provide virtual reality (VR)-support in implementing surgical procedures, with additional correct control of all risks, within the limits of surgical normal tissue, without additional trauma to the surrounding tissue in the anatomic region undergoing surgical treatment, while having an impression of the presence in virtual world, navigating through it and manipulating with virtual objects. 3D image analysis and processing, tissue modelling, virtual endoscopy (VE), virtual surgery (VS), the use of rapid prototyping (RP) models in medicine, 3D-computer assisted surgery (3D-CAS), as well as tele-3D-CAS, are a new methods of diagnosis using computer processing of 3D image datasets to provide simulated visualizations of patient specific organs similar or equivalent to those produced by standard 2D-black and white MSCT, MRI images and/or endoscopic procedures, and in the same time represent a basis for various realistic simulations in medicine, and can definitely create an impression of immersion of a physician in a non-existing virtual environment.  Visualization avoids the risks associated with real endoscopy, and when used prior to performing an actual endoscopic exam can minimize procedural difficulties  and decrease the rate of morbidity, especially for endoscopists in training which was proved in our first 3D-CA-FESS in June 1994, and  Tele-3D-CA-FESS in October 1998.  If we would like to understand the idea of “virtual reality” (VR), it is necessary to recognize that the “… perception of surrounding world created in our brain is based on information coming from the human senses and with the help of a knowledge that is stored in our brain”. The usual, well known definition says that the impression of being present in a virtual environment, such as VE/tele VE of the patient’s head, that does not exist in reality is called virtual reality (VR). Now, imagine that we can substitute artificially generated sensations for the real standard daily information received by our senses. In this case, the perception system in humans could be deceived, creating an impression of another 'external' world around the man. In this way, we could replace the true reality with the simulated reality that enables precise, safer and faster diagnosis as well as surgery. All systems of simulated reality share the ability to offer the user to move and act within the apparent worlds instead of the real world. The otorhinolaryngologist, e.g., any member of our surgical team, was able to provide VR-support in implementing surgical procedures, with additional correct control of all risks, within the limits of surgical normal tissue, without the additional trauma of surrounding tissue of anatomical region which has undergone surgical treatment, and in the same time they had the impression of presence in the virtual world and could navigate through it and manipulate with virtual objects.


II. PREDAVANJA (2014-2016)

II. I. 3. CROATIAN RHINOLOGIC CONGRESS, ZAGREB, HRVATSKA (veljača, 2014.)
http://www.3rhinocongress.org/programme.asp
1. OKRUGLI STOL (Prof. Klapan / pozvani predavač/tajnik kongresa/voditelj): CAS - Virtual reality and 3D-navigation operating planning systems in rhino environments

PREDAVANJE: Virtual reality and 3D-navigation operating planning systems in rhino environments.

SAŽETAK: Additional research in the area of 3D image analysis, visualization, tissue modelling, and human-machine interfaces provides scientific expertise necessary for developing successful 3D visualization of the human head during 3D-CAS, Tele-3D-CAS, and other VR (virtual reality)  applications. Such an impression of immersion can be realized in any medical institution using advanced computers and computer networks that are required for interaction between a person and a remote environment, with the goal of realizing tele-presence. If we would like to understand the idea of VR, it is necessary to recognize that the perception of surrounding world created in our brain is based on information coming from the human senses and with the help of a knowledge that is stored in our brain. The usual definition says that the impression of being present in a virtual environment, such as virtual/tele virtual endoscopy of the patient’s head, that does not exist in reality, is called VR. Now, imagine that we can substitute artificially generated sensations for the real standard daily information received by our senses. In this case, the perception system in humans could be deceived, creating an impression of another 'external world around the man (e.g., during standard 3D navigation surgery). In this way, we could replace the true reality with the simulated reality that enables precise, safer and faster diagnosis as well as surgery. All systems of simulated reality share the ability to offer the user to move and act within the apparent worlds instead of the real world. Any otorhinolaryngologist, member of my surgical team, has impression of presence in the virtual world and can navigate through it and manipulate virtual objects (www.poliklinika-klapan.com).  Literatura: Klapan I, et al. (2006) Ear Nose Throat J, 85(5):318-321.; (2008) Coll Antropol, 32(1):217-219. (2011) Virtual Reality in Medicine, ISBN 978-953-307-518-1, Intech, 303-336.

 

II. II. CORLAS 2014 - COLLEGIUM OTORHINOLARYNGOLOGICUM AMICITIAE SACRUM, ISTANBUL, TURSKA (kolovoz 2014)  http://www.collegium2014.com
1. OKRUGLI STOL- RINOLOGIJA (Prof. Klapan / pozvani predavač): I. Virtual reality (VR) and 3D-navigation-CAS i II. Virtual reality and 3D-navigation operating planning systems in rhino environments

SAŽETAK: BACKGROUND: Additional research in the area of 3D image analysis, visualization, tissue modelling, and human-machine interfaces provides scientific expertise necessary for developing successful 3D visualization of the human head during navigation-3D-CAS, tele-3D-CAS, and other VR (virtual reality)  applications. The usual definition says that the impression of being present in a virtual environment, such as VE/tele-VE of the patient’s head, that does not exist in reality, is called VR. If we would like to understand the idea of VR, it is necessary to recognize that the perception of surrounding world created in our brain is based on information coming from the human senses and with the help of a knowledge that is stored in our brain. STUDY DESIGN:  Ordinary, and occasionally even expert surgeons may need some additional intraoperative consultation (or VE/3D support), for example, when anatomical markers are lacking in the operative field due to trauma, war injuries, bleeding, etc. Now, imagine that we can substitute artificially generated sensations for the real standard daily information received by our senses. In this case, the perception system in humans could be deceived, creating an impression of another “external world” around the man. RESULTS: What will ENT surgery look like in the next decade? Systematic approach will be combined with modern tools for medical imaging and additive manufacturing: computer-based system for virtual endoscopic assistance, extending physician’s visualization and orientation in the anatomical space, comprehensive detailed 3D procedure planning with possibility to prepare and consider several scenarios quickly, follow-on illustration-piloted endoscopy, real-time processing and fusion of the 3D-MSCT data and endoscopic video that helps preventing undesirable intrusions into sensitive areas with instruments during surgical procedures, additional visual tools about objects examined/implemented in system (layers, volume, surface distances), tangible and realistic models produced with additive manufacturing technologies, virtual planning and simulation of operation  various  surgeries, with complex spatial relationships. CONCLUSIONS:  All systems of simulated reality share the ability to offer the user to move and act within the apparent worlds instead of the real world. Any member of my surgical team, has impression of presence in the virtual world and can navigate through it and manipulate with virtual objects, and replace the true reality with the simulated reality that enables precise, safer and faster diagnosis as well as surgery. 


II. III. ISIAN-IRS-PARS - International Society of Infection and Alergy of the Nose, Internatioanl Rhinology Society and Pan Arab Rhinology Society, 2014, DUBAI, UAE (studeni, 2014) http://isian-irs-pars2014.org
(Prof. Klapan, faculty/pozvani predavač)

SAŽETAK: Do we need a new sinus surgery technique in a daily routine practice? Imagine that the perception system in humans could be deceived, creating an impression of another „external“ world(1) where we can replace the „true reality“ with the „simulated reality“ that enables precise, safer and faster diagnosis/surgery(2). Of course, we tried to understand the new, visualized „world of the patient's head“ by creating an impression of virtual perception of the given position of all elements in the patient's head, which does not exist in the real world (virtual world/VW)3. This approach was aimed at upgrading diagnostic work-up and endoscopic surgery by ensuring a faster and safer operative procedure, and represent a basis for realistic simulations, and can create an impression of immersion of a physician in a non-existing virtual environment(4). Every ENT specialist will be able to provide VR support in implementing surgical procedures, with additional correct control of all risks, without additional trauma, while having an impression of the presence in VW, navigating through it and manipulating with virtual objects (3D CA navigation)5. Furthermore, when the 3D surface with tissues arranged by objects is obtained, it is possible to derive spatial cross-sections at selected cutting planes, thus providing additional insight into the internal regions observed (Osirix/Leap Motion & NES 3D volume rendering models)6. A tele-presence system extends the operator’s sensory-motor facilities and problem solving abilities to a remote environment, providing the local operator with necessary sensory information to simulate operator’s presence at the remote location (3D surgical planner with remote visualization)1,7. Generally speaking, fly-through techniques, which combine the features of endoscopic viewing and cross-sectional volumetric imaging, provide more effective and safer endoscopic procedures (marker-based VR simulation), and use the corresponding cross-sectional image or multiplanar reconstructions to evaluate anatomical structures during the operation (3D navigation and augmented reality in the operating room)8. Literatura: Klapan I, et al.  Virtual Reality in Medicine(1) 2011; Otolaryngol Head Neck Surgery(6,7,8) 2002/2003/2005; Ear Nose Throat J(2,3) 2006/2016; Coll Antropol(4,5) 2008/2016


II. IV. 4. CROATIAN RHINOLOGIC CONGRESS, ZAGREB, HRVATSKA (veljača, 2016.)
I OKRUGLI STOL (Prof. Klapan / moderator/pozvani predavač/tajnik kongresa): ESS (Endoscopic sinus surgery)

II OKRUGLI STOL  (1st  ROUND TABLE) (Prof. Klapan/moderator), pozvani predavač: What is the future of minimally invasive sinus surgery: computer assisted navigation, marker-based virtual reality simulation, or 3D-surgical planner with remote visualization, 3D-navigation and augmented reality in the operating room?

Invited speakers:  T. Braut (Croatia), T. Terzis (Greece), M. Kavanah (Croatia), I. Konstantinidis (Greece), I. Klapan (Croatia), T. Baudoin (Croatia)

PREDAVANJE: Rhinophotodynamic therapy in the treatment of sinonasal polyposis (SNp)

SAŽETAK: AIM OF STUDY: a) to assess the mechanisms, therapeutic efficacy and potential effect of rhinophotodynamic therapy (RPDT; per viam terminal deoxynucleotidyl transferase dUTP nick end labelling/TUNEL-assay), for detection of epithelial/ inflammatory cell apoptosis in light-exposed control and sinonasal polyps (SNp) tissue samples, as well as b) the role of inflammatory mediators (AAm; per viam ELISA test) in the development of SNp. PRESUMPTION: Based on the nasal/sinus mucosa hypertrophy in CRS, we expected preoperatively an elevated concentration of AAm in biopsy specimens of chronically altered sinonasal mucosa, as compared with normal mucosa (1), as well as to find a significantly lower concentration of AAm in biopsy specimens of chronically altered SNp mucosa, and absent or substantially reduced mass in RPDT treated SNp. STUDY DESIGN: UV/VIS RPDT uses a mixture of the light of visible and UV wavelength (λ=310-650 nm). The UV-wavelength light significantly reduces the number of memory T-cells, in particular T-cells responsible for the production of IL-5, and via the mechanism of “programmed death” (apoptosis), also directly reduces eosinophil (Eo) count and the Eo-cationic protein activity (these cells directly influence reduction in the number of Eo cells, as one of the most active effector cell lines in allergologic reaction). UVA-light blocks the release of histamine from basophilic and mast cells, while UVB-light has the same additive effect on mast cells. The SNp specimens, collected upon FESS, were cut into pieces, in vitro irradiated with various doses of UV/VIS, and than selectively with UV and VIS. Histopathologic diagnosis was made by SNp specimen treatment with 5-delta-aminolevulinic acid/DALA, followed by irradiation with VIS light. Upon final SNp tissue storage paraffin blocks, TUNEL-assay was performed to detect apoptosis on epithelial and inflammatory cells in the irradiated and control SNp tissue specimens. CONCLUSION: Intranasal RPDT has proved efficacious in SNp therapy (sinus and nasal SNp mass significant reduction), as confirmed by determination of induced epithelial cell and subepithelial leukocyte apoptosis, followed by significant reduction of synthesis of AAm metabolites. Literatura: Klapan I, et al.Am J Otolaryngol (1995) (1)


IV.I. POZVANA PREDAVANJA (2017)
1. Prof. Klapan / počasni pozvani predavačl, Global Conference on Otolaryngology, ožujak, Dubai, UAE
2. Prof. Klapan / Član / Organizing Committee ENT 2016,  International Conference on Ear, Nose and Throat Disorders (ENT Conference 2017), srpanj, Kuala Lumpur, Malezija,
3. 5th International Conference on Otorhinolaryngology, kolovoz, London, Velika Britanija
4. Prof. Klapan / pozvani predavač, Rhinology World Congress , "New Technology in Rhinology", kolovoz, Hong Kong
5. Prof. Klapan / workshop and symposium presentation, "Global Surgeons Meet", listopad, Paris, Francuska
6. Prof. Klapan / pozvani počasni predavač, International Conference on "Head and Neck: The Multidisciplinary Approach", Dubai, prosinac, UAE

IV.II. POZVANA PREDAVANJA (2018)
1. Prof. Klapan / član organizacijskog odbora kongresa / pozvani predavač / član uredničkog kolegija / za sve znanstvene časopise povezane s kongresom (2018): ENT Conference 2018; Breakthrough to Excellence in ENT Treatment, travanj, Dubai, UAE,
2. Prof. Klapan / član organizacijskog odbora kongresa/ pozvani predavač i član organizacijskog borda kongresa/ Conference Related Journals (2018): ENT Conference 2018; Breakthrough to Excellence in ENT Treatment, svibanj, Osaka, Japan,
3. Prof. Klapan / pozvani počasni predavač, "EURO-SURGERY-2018", kolovoz, Prag, Republika Češka
4. Prof. Klapan / pozvani počasni predavač,  "3rd European Otolaryngology-ENT Surgery Conference", listopad, London, Velika Britanija
5. Prof. Klapan / član organizacijskog odbora kongresa / pozvani predavač: 8th International Conference on Otorhinolaryngology; Otorhinolaryngology: Modern Innovations and Clinical Aspects, listopad, Rim, Italija
6. Prof. Klapan / Invited Honorable Speaker, International Conference on "Head and Neck: The Multidisciplinary Approach, prosinac, Dubai, UAE

IV.III. POZVANA PREDAVANJA (2019)    
1. Prof. Klapan / pozvani počasni predavač, "EURO-SURGERY-2019", ožujak,  Budimpešta, Mađarska
2. Prof. Klapan / pozvani počasni predavač, "2nd Edition of European Conference on Otolaryngology, ENT Conference", svibanj, Singapur
3. Prof. Klapan / pozvani počasni predavač, Workshop Chairman,  "European conference on Ears, Nose and Throat Disorder 2019", svibanj, Stockholm, Švedska,  
4. Prof. Klapan / pozvani počasni predavač , "3rd World Congress on Surgery & Anesthesia", lipanj, Berlin, Njemačka
5. Prof. Klapan / pozvani počasni predavač, "Collegium Otorhinolaryngologicum Amicitiae Sacrum Annual Meeting," kolovoz, Bern, Švicarska
6. Prof. Klapan / član organizacijskog odbora kongresa and pozvani predavač, "Global Conference on Surgery and Anaesthesia", listopad, Dubai, UAE 
7. Prof. Klapan / pozvani počasni predavač , "9th International Conferrence on Otolaryngology", listopad, Tokyo, Japan  
8. Prof. Klapan / počasni pozvani predavač / član organizacijskog odbora kongresa, "Otolaryngology-2019, 3rd Global Summit on Otolaryngology 2019", studeni, Amsterdam, Nizozemska

IV.IV. POZVANA PREDAVANJA (2020)  
1. Prof. Klapan / počasni pozvani predavač / član organizacijskog odbora kongresa,  Worlod Congress on Otology, Rhinology & Laryngology , ožujak, Dubai, UAE; Predavanje: "Utilization of 3D medical imiging    and touch-free navigation in endoscopic surgery: does our current technologic advancement represent the future in innovative contactless noninvasive surgery in rhinology? What is next?    
2. Prof. Klapan / počasni pozvani predavač / član organizacijskog odbora kongresa,  Dissseminating Advance Research and Innovative Tectnology in the Field of Surgery, travanj, Amsterdam, Nizozemska
3. Prof. Klapan / počasni pozvani predavač, "10th International Conference od Otolaryngology; "Otolaryngology: Modern Innovation and Scientific Aspects", lipanj, Paris, Francuska
4. Prof. Klapan / počasni pozvani predavač / član organizacijskog odbora kongresa, "International Conference on Surgery and Anesthesia (ICSA-2020)", rujan, Paris, Francuska
5. Prof. Klapan / počasni pozvani predavač / član organizacijskog odbora kongresa, "Surgery World Forum", listopad, Toronto, Kanada 

IZABRANA PREDAVANJA

1. Klapan I, Duspara A, Majhen Z, Benić, Žagar M, Stranjak A. What is the future of minimally invasive ENT surgery: augmented  reality in the operating room, 3D-surgical planner with remote visualization or computer assisted navigation with contactless hand-gesture non-invasive surgery based on the development of swarm intelligence applications? Collegium Otorhinolaryngologicum  Amicitiae Sacrum (CORLAS) Annual Meeting, Bern, Švicarska (2019) (Klapan, pozvani predavač)

Acknowledgment: The authors are grateful to Professor Heinz Stammberger, M.D.(†), Graz, Austria, EU, for his helpful discussion about NESS and contactless surgery (February/2018)

SAŽETAK: Background: this study presents (a) the use of our original contactless interface as a plug-in application for OsiriX DICOM-viewer platform, using a hardware sensor device controller (LeapMotion and/or  RealSenseIntelDepthCamera) that supports hand and finger motions as an input, with no hand contact, touching and/or voice navigation, (b) modification of standard classical surgical parameters per viam on the fly gesture-controlled incisionless surgical interventions. Materials and Methods: a) marked anatomic regions of interest were sorted in a way that makes sense for different operation stages, b) accuracy analysis of computer generated models were done according to Knežević M. et all (Surgical Innovation, 2017) c) our original plug-in application (intellectual property protected by copyright) provided  different types of gestures for 3D-virtual reality navigation, d) our hardware sensor device, that controls the system without touching any other device, served  as an interface for camera positioning in 3DVE-views, e) impression of panoramic 3D-virtual reality-viewing was given by pivoting the camera around a focus fixed on the object. Results: a) this novel technique enables surgeons to get complete and aware orientation in the operative field, where “overlapping” of the real and virtually created anatomic models is inevitable,  b) this new “spatial experience” must be comprehensively and correctly recognized in each segment of the operation, c) our human mind and understanding of this new surgery works by creating completely new models of human behavior and understanding spatial relationships, along with devising assessment that will provide an insight into our human nature, and d) any model and/or virtual model of surgical field is defined as it actually exists in its natural surroundings. Discussion and Conclusion: we offered an alternative to closed software  systems for visual tracking, and also developed also the software  framework that will interface with depth cameras and provide a set of standardized methods for medical applications such as hand gestures and tracking, face recognition, navigation, etc (www.bitmedix.com). This software  should be an open source, operation system agnostic, approved for medical use and independent of hardware. Comparison of previous doctrines in surgical branches of human medicine clearly indicates that manipulation with 3D volume rendering slices of the human anatomy per viam touchless surgical navigation system with simulation of virtual activities has become reality in the operation room/virtual reality field, and in the future will be a part of medical decentralized, self-organized “Swarm Intelligence“  systems, in a variety of virtual reality fields in clinical medicine and fundamental research.

2. Klapan I. Žagar  M, Mutka A, Majhen Z. 3D-image-guided navigation with touchless gesture user interface during minimally invasive head and neck surgery: do we have "biomechanics" of the new era in our personalized contactless hand-gesture non-invasive surgeon-computer interaction? 

Collegium Otorhinolaringologicum Amicitiae Sacrum (CORLAS) Annual Meeting, Vienna, Aiustria (2024) (Klapan, pozvani predavač)

SAŽETAK:  In modern operation rooms (OR), with the innovative application of medical informatics, it is possible to enable many aspects of surgeries that were not able to be addressed before. Definitely, one of these is contactless surgery (CS), with planning and controlling the visualization of medical data. We started our initial research by applying virtual reality (VR) concepts in our first Tele-3D-CAS in rhinology (1998), where we implemented a new framework for the transfer of computer data (images, 3D models) in real-time during the surgery and, in parallel, of the encoded live video signals. We demonstrated this approach with an example of our 3D-computer assisted navigation rinosurgery (1994) with simulation and planning of the course of a subsequent endoscopic operation per viam virtual endoscopy/surgery (VE/VS), which overcomes some difficulties of conventional endoscopies, such as “standard” FESS or Tele-FESS. In our CS-concept (from 2017-2024), especially based on our latest EU-research “EU-EIT Health RIS Innovation 2020 Grant”, we were focused:  a) on improving the “In the Air” human–computer interaction during surgery in the clinical environment, b) set the problem of navigation through the human body, c) our input modalities for surgeon–computer interaction and motion recognition methods used for controlling the contactless 3D-VE, d) completely new framework for hand and motion detection based on augmented reality (AR), e) we developed a contactless interface for a surgeon to control the visualization options in our DICOM-viewer platform, that uses a stereo camera as a sensor device input that controls hand/finger motions in contactless mode, and applied it to 3D-VE and 3D-VS, f) our proposal for defining motion parameters in contactless, incisionless surgeries, g) we implemented motion tracking using stereo cameras with depth resolution and precise shutter sensors for depth streaming, h) our CS-provides contactless control with a range up to 2–3 m that definitely enables the application in the OR. In modern medical world, the surgeon, as a 21st-century man, thinks differently, with a new visualization aspect and understanding of the ecosystem, visualization space, and self-and anatomy-awareness of his patients. Our newest CS-approach could be an important step towards the strategy of enhancing surgeons’ capacities and increasing their overall satisfaction and precision since we enable the integration of real and virtual objects in the surgical field, which enables better surgeon’s experience, more precise surgery, real-time feedback, depth motion tracking, and contactless control of visualization, which gives freedom to the surgeon during the surgery. However, does our CS really represent the future of smart surgery? Do we really have real technological advances in ENT-surgery in our hands, as the great Professor Heinz Stammberger once said?

3. Klapan I, Majhen Z, Žagar M, Mutka A. 3D-image-guided navigation with touchless gesture user interface during minimally invasive head and neck surgery. 2nd European Congress biomedical and veterinary engineering 2024 – BioMedVetMech 2024, Zagreb, Croatia, EU (Klapan, pozvan i predavač)

PREDAVANJE: Application of advanced virtual reality and 3D-computer assisted technologies in ness.

SAŽETAK:  In the modern-day world medical technology, NESS systems represent the technique with highly precise, extremely small navigation instruments which guides the surgeon through the software (1), provides the most flexible OR setup,  with automatic recognition of the surgeon’s intent during the procedure (2), and with no need to press a button, but with some functional limitations. If surgeons would need additional information (e.g. how deep, and where the pathologic process invaded standard “s.c. normal mucosal layer inside the sinus”, etc)(3), do they have appropriate, and sufficient support given by NESS, just even in very simple cases? The answer is “no”! But with additional application of several (semi) automatic tools (e.g. wave-propagation, skeleton-based approaches, and methods based on depth-maps)(4), developed as  „simulated spaces“ (artificial reality), it is possible to provide appropriate support in OR (detection of regions of interest, structural & functional analyses, data-driven visualization techniques for data exploration)(5). From the very beginning of my 3D-CA-NESS (1994)(6,7), and tele3D-CA-NESS (1998), 3D image analysis and processing, tissue modelling, and virtual endoscopy/surgery, represented a basis for various realistic simulations in standard FESS.  The possibility of exact preoperative, non-invasive visualization of the spatial relationships of anatomic and pathologic structures, including extremely fragile ones, size and extent of pathologic process, and of precisely predicting the course of surgical procedure (8), allowed me considerable advantage in the preoperative examination of the patient and to reduce the risk of intraoperative complications (all this by use of different VR methods)(9). Real-time VR technology will update the 3D graphical visualization of the patient’s anatomy, providing a highly useful and informative visualization of the regions of interest, thus bringing advancement in defining the geometric information on anatomical contours of 3D human head models by the transfer of so-called “image pixels to contour pixels”.  

4. Klapan I. I. What is the future of minimally invasive rhinosurgery: 3D-surgical planner/navigation, augmented reality in the operating room, marker-based VR-simulation with touch free surgeon's commands, or the AI-supported contactless-CAS as a "biomechanics" of the new era in personalized contactless hand-gesture noninvasive rhinosurgery?  II. Virtual reality in medicine:  modern 3D-navigation integrated rhinosurgery of the 21 century. International Conference on Otology, Rhinology & Laryngology, April 25, 2025, Vienna, Austria. (Klapan, plenary lecture)

SAŽETAK: Objectives: 3D image analysis and processing, tissue modelling, virtual endoscopy and surgery (VE, VS), 3D-computer assisted surgery (3D-CAS), as well as tele-3D-CAS, represent a basis for various realistic simulations in medicine, and can definitely create an impression of immersion of a physician in a non-existing virtual environment.  In rhinology, such an revolutionary approach is of paramount importance for the surgeon because of the proximity of intracranial structures and limited operative field layout hampering spatial orientation during the “standard” operative procedure. The possibility of exact preoperative, non-invasive visualization of the spatial relationships of anatomic and pathologic structures, including extremely fragile ones, size and extent of pathologic process, and of precisely predicting the course of surgical procedure, allows the surgeon to achieve considerable advantage in the preoperative examination of the patient and to reduce the risk of intraoperative complications, all this by use different VR methods. Methods: From the very beginning of our 3D-navigation-CAS and tele-3D-navigation-CA-surgeries (1994), the modeling was done by use of the VolVis, Volpack/Vprender, GL Ware programs on a DEC Station 3100 computer. With the advent of 3D Viewnix V1.0 software, we started using this program, and then 3D Viewnix V1.1 system, AnalyzeAVW system, T-Vox system and OmniPro 2 system on Silicon Graphics O2, Origin200 and Origin2000 computers. My team used several standards to encode live video signals in telesurgery, such as M-JPEG, MPEG1, MPEG2 and MPEG4. For conferencing/consultation cameras used between two or more connected sites during the surgery, we used JPEG and MPEG1 stream with audio. ORs were connected using several computer network technologies with different bandwidths, from T1, E1 and multiple E1 to ATM-OC3 (from 1Mb/s to 155Mb/s). For computer communications using X-protocol for image/3D-models manipulations, we needed an additional 4Mb/s of bandwidth, instead of the 1Mb/s when we used our own communication tools for the transfer of surgical instrument movements. Discussion: The real-time requirement means that the simulation must be able to follow the actions of the user that may be moving in the virtual environment. The computer system must also store in its memory a 3D model of the virtual environment (3D-CAS models). In that case a real-time virtual reality (VR) system will update the 3D graphical visualization as the user moves, so that up-to-date visualization is always shown on the computer screen. Upon the completion of the CAS and/or tele-CAS-operation, the surgeon compares the preoperative and postoperative images and models of the operative field, and studies video records of the procedure itself. In otorhinolaryngology, especially in rhinology, research in the area of 2D and 3D image analysis, visualization, tissue modelling, and human-machine interfaces provides scientific expertise necessary for developing successful VR-applications. The basic requirement in rhinology, resulting from the above mentioned needs refers to the use of a computer system for visualization of anatomic 3D-structures and integral operative field to be operated on. To understand the idea of 3D-CAS/VR it is necessary to recognize that the perception of surrounding world created in our brain is based on information coming from the human senses and with the help of a knowledge that is stored in our brain. The usual definition says that the impression of being present in a virtual environment, such as virtual endoscopy (VE) of the patient’s head, that does not exist in reality, is called VR. The user/physician, has impression of presence in the virtual world and can navigate through it and manipulate virtual objects. A 3D-CAS/VR system may be designed in such a way that the physician, is completely immersed in the virtual environment. Conclusions: VR applications as well as 3D reconstruction of anatomic units becomes a routine preoperative procedure, as we already shown in our surgical activities in the last two decades (our first navigation-CAS-FESS/May 1994, tele-3D-CAS-FESS/October 1998), providing a highly useful and informative visualization of the regions of interest, thus bringing advancement in defining the geometric information on anatomical contours of 3D-human head-models by the transfer of so-called “image pixels” to “contour pixels”. The possibility of data analysis and storage in the 3D form and development of 3D centers at clinical institutions should provide a new quality in proper training of future surgeons in CAS as well as tele-CAS activities.

5. Klapan I, Žagar M, Majhen Z, Mutka A.What is the future of minimally invasive rhinosurgery: 3D-surgical planner/navigation, augmented reality in the operating room, marker-based VR-simulation with touch free surgeon's commands, or the AI-supported contactless-CAS as a "biomechanics" of the new era in personalized contactless hand-gesture noninvasive rhinosurgery?  European Rhino Congress (ERS & ISIAN-IRIS  lipanj, 2025) Budimpešta, Mađarska.

SAŽETAK: Artificial Inteligence (AI) define the concept of personalized medicine and thereby inevitably determine the future of surgery/rhinosurgery/medicine in its overall form with enormous potential for transforming diagnostic/terapeutic procedures into the best possible solutions.Our team developed the foundational principles of contactless surgery/CS, focusing on its core elements such as 3D volumetric rendering/real time visualization/gesture based manipulation only in 3D-virtual world „that doesn't exist in reality“. By eliminating the need for constant translation between 2D-3D representations, CS offers a promising solution to the cognitive biases induced by traditional surgical visualization methods.Our CS-concept (from 2017-2025; “EU-EIT Health-RIS-Innovation-2020-Grant”), is focused:  a) “In the air” human/computer interaction during surgery in the clinical environment, b) completely new original framework for hand and motion detection based on augmented reality, c) we developed a contactless interface for a surgeon to control the visualization options in our DICOM-viewer platform, that uses a stereo camera as a sensor device input that controls hand/finger motions in contactless anatomy), d) implementation of motion tracking using stereo cameras with depth resolution and precise shutter sensors for depth streaming. Our newest CS-approach represents an important step towards the strategy of enhancing surgeons’ capacities and increasing their overall satisfaction and precision since we enable the integration of real and virtual objects in the surgical field, which enables better surgeon’s experience, more precise surgery, real-time feedback, depth motion tracking, and contactless control of visualization, which gives freedom to the surgeon during the surgery.

5. Klapan I. I. Utilization of 3-D medeical imaging and touch-free navigation in endoscopic surgery: does our current technologic advancement represent the future in innovative contactless noninvasive surgery in rhinology? What is next? i  Klapan I. II. Application of modern techniques in Sinonasal Surgery: Real time transfer of live Video Images in 3D-CAS and Tele-3D-CAS in Rhinology. International Conference on ENT and Related Disorders, November 24-25, in Paris, France (Klapan, plenary lecture).

SAŽETAK: Objectives: During Tele-3D-surgery, the computer with its operative field image allows the surgeon, by means of up-to-date technologies, to connect the operative instrumentarium to spatial digitalizers connected to the computer. Upon the completion of the tele-operation, the surgeon compares the preoperative and postoperative images and models of the operative field, and studies video records of the procedure itself. Methods: The surgeon and consultants use software for CT image previews and 3D-model manipulations on top of collaboration tools to define the pathology, to produce an optimal path to the pathology and to decide how to perform the real surgery. Using tele-fly-through or tele-VE through 3D-models, both surgeons can preview all the characteristics of the region, and so predict and determine the next steps of the operation. Results: We used several standards to encode live video signals in telesurgery, such as M-JPEG, MPEG1, MPEG2 and MPEG4. It has been definitely concluded that MPEG4 streams, without audio, have the best picture quality for the operating field/endo camera. For conferencing/consultation cameras used between two or more connected sites during the surgery, we used JPEG and MPEG1 stream with audio. ORs were connected using several computer network technologies with different bandwidths, from T1, E1 and multiple E1 to ATM-OC3 (from 1Mb/s to 155Mb/s). For computer communications using X-protocol for image/3D-models manipulations, we needed an additional 4Mb/s of bandwidth, instead of the 1Mb/s when we used our own communication tools for the transfer of surgical instrument movements. The final step of this project is to create an extremely large uncompressed database (2x47 TB), where all multimedia content will be saved into a massive database with a maximum resolution, and in a format not depending on a resolution. In a case when this is impossible, e.g. with video content (movies), then the compression is as small as possible so that the content is able to maintain the highest quality accessible. For instance, audio data are saved on media for data in a linear format, without any loss in quality. Conclusions: Using intraoperative records, animated images of the real tele-procedure performed can be designed. Beside otorhinolaryngology, this has also been used in other fields. The more so, in addition to educational applications, VS offers the possibility of preoperative planning in sinus surgery, and has become a very important segment in surgical training and planning of each individual surgical or telesurgical intervention, not only in the reigon of paranasal sinuses. Our tele-3Dsurgery allows surgeons not only to see and to transfer video signals, but also to transfer 3D computer models and surgical instrument movements with image/3D-model manipulations, in real time during the surgery. Literatura: a) Klapan I, Šimičić Lj, Rišavi R, Bešenski N, Bumber Ž, Stiglmajer N, Janjanin S. Dynamic 3D computer-assisted reconstruction of metallic retrobulbar foreign body for diagnostic and surgical purposes. Case report: orbital injury with ethmoid bone involvement. Orbit, 2001, 20(1):35-49. b) Klapan I, Šimičić Lj, Rišavi R, Bešenski N, Pasarić K, Gortan D, Janjanin S, Pavić D, Vranješ Ž. Tele-3D-Computer Assisted Functional Endoscopic Sinus Surgery: new dimension in the surgery of the nose and paranasal sinuses. Otolaryngology Head Neck Surg, 2002, 127:549-557. c) Klapan I, Šimičić Lj, Rišavi R, Pasari K, Sruk V, Schwarz D, Barišić J. Real time transfer of live video images in parallel with three-dimensional modeling  of the surgical field in computer-assisted telesurgery. J Telemed Telecare, 2002, 8:125-130. d) Klapan I, Šimičić Lj, Bešenski N, Bumber Ž, Janjanin S, Rišavi R, Mladina R. Application of 3D-computer assisted techniques to sinonasal pathology. Case report: war wounds of paranasal sinuses with metallic foreign bodies. Am J Otolaryngol, 2002, 23(1):27-34.


V. PRIMJENA NOVIH TEHNIKA U KIRURGIJI GLAVE I VRATA (prof.dr. I. Klapan, primjeri operacija; 2000-2023)

NAPREDNE 3D-NAVIGACIJSKE-KOMPJUTORIZIRANE OPERACIJE NOSA, SINUSA, ORBITE I BAZE LUBANJE (PRIMJENA KOMPJUTORIZIRANIH "RP-MODELA" GLAVE BOLESNIKA TIJEKOM OPERACIJE, U REALNOM VREMENU): IZBOR OPERACIJA
V.I. * Tm. nosa, paranazalnih sinusa, baze lubanje, epifainksa/orofarinksa
Navigacijska-3D-CA-RP-FESS-operacija nosa, sinusa i baze lubanje

V.II. * Tm. maksilarnog sinusa, kronične promjene sluznice nosa i paranazalnih sinusa
Navigacijska-3D-CA-RP-FESS-operacija nosa i sinusa

V.III. * Meningokela frontalnog sinusa. Kronični purulentni polisunusitis (lijevostrani frontalni, ant/post etmoidini i maksilarni sinus)
Navigacijska-3D-CA-RP-FESS-operacija nosa, sinusa i baze lubanje

V.IV. * Tm. orbite i ant/post etmoidnih celula (sinusa). Destrukcija/konzumacija laminae papiraceae desnostrane orbite, dislokacija istostrane očne jabučice, medijalnog i lateralnog m. rectusa, kao i očnog živca
Navigacijska-3D-CA-RP-FESS-operacija nosa, sinusa, orbite i baze lubanje


VI. OBJAVLJENE PUBLIKACIJE DJELATNIKA/KONZULTANATA POLIKLINIKE KLAPAN MEDICAL GROUP (2011-2022)

VI.I. KNJIGA "VIRTUAL REALITY" (APLIKACIJE U MEDICINI) (2011)

Klapan Ivica et al. Application of Advanced Virtual Reality and 3D Computer Assisted Technologies in Computer Assisted Surgery and Tele-3D-computer Assisted Surgery in Rhinology , Book "Virtual Reality" (ed. J.J. Kim) pgs 291-325, ISBN 978-953-307-518-1, Intech (published by), 2011. (The permanent web address of our chapter can be reached by clicking on the link http://www.intechopen.com/articles/show/title/application-of-advanced-virtual-reality-and-3d-computer-assisted-technologies-in-computer-assisted-s)
Paper/title: "Klapan, I: Application of Advanced Virtual Reality and 3D Computer Assisted Technologies in Computer Assisted Surgery and Tele-3D-Computer Assisted Surgery in Rhinology" (BOOK TITLE: Virtual Reality) has been downloaded 4000 times to April 21, 2017.
"Such readership results demonstrate some very important factors about the reach and usage of this InTechOpen published research: a) more than 4000 researchers worldwide read, downloaded and interacted with your published content, b) this achievement demonstrates the influence your research has had within the scientific community, and c) researchers from all over the world have been able to connect with your research to obtain relevant information to further develop their own research projects (InTechOpen Book Stats; http://www.intechopen.com)".

VI.II. ZNANSTVENI RADOVI DJELATNIKA POLIKLINIKE KLAPAN MEDICAL GROUP (2015-2025)

  1. Raos P, Klapan I, Galeta T. Additive Manufacturing of Medical Models - Applications in Rhinology. Collegium Antropol 2015;39(3):667-73 (ISSN 0350-6134) (CC)
  2. Klapan I, Raos P, Galeta T, Kubat G. Virtual reality in rhinology – a new dimension of clinical experience. Ear Nose Throat. 2016; 95(7): 23-28 (CC)
  3. Klapan I, Duspara A, Majhen Z, Benić I, Kostelac M, Kubat G, Berlengi N. What is the future of minimally invasive surgery in rhinology: marker-based virtual reality simulation with touch free surgeon's commands, 3D-surgical navigation with additional remote visualization in the operating room, or ...? Frontiers in Otolaryngology-Head and Neck Surgery 2017; 1(1): 1-7
  4. Klapan I, Duspara A, Majhen Z, Benić I, Kostelac M, Kubat G, Berlengi N, Zemba M, Žagar M. What is the future of minimally invasive sinus surgery: computer assisted navigation, 3D-surgical planner, augmented reality in the operating room with 'in the air' surgeon's commands as a "biomechanics" of the new era in personalized contactless hand-gesture noninvasive surgeon-computer interaction? J Scientific Technical Research  2019; 19(5):14678-14685. 
  5. Klapan I, Duspara A, Majhen Z, Benić I, Trampuš Z, Žagar M, Kubat G, Berlengi N, Zemba M, Klapan L, Ešler M. Do we really need a new innovative navigation-non-invasive on the fly gesture-controlled incisionless surgery? J Scientific Technical Research  2019; 20(5): 15394-15404.
  6. Klapan I, Majhen Z, Žagar M, Klapan L, Trampuš Z, Berlengi N, Zemba M, Ljubičić A, Ešler M. Utilization of 3-D medeical imaging and touch-free navigation in endoscopic surgery: does our current technologic advancement represent the future in innovative contactless noninvasive surgery in rhinology? What is next? J Scientific Technical Research 2019; 22(1):16336-16344.
  7. Klapan I, Žagar M, Majhen Z, Klapan L, Trampuš Z, Kostelac M, Berlengi N, Zemba M, Ljubičić A, Ešler M. Do we have "biomechanics" of the new era in our personalized contactless hand-gesture non-invasive surgeon-computer interaction? J Biomedical Science Research 2021; 3(2):1-6. ISSN: 2582-077X
  8. Žagar M, Mutka A, Klapan I, Majhen Z. Hand and Gesture Module for Enabling Contactless Surgery. Trends Telemed E-Health 3(1). TTEH. 000553. Crimson Publishers, 2021. DOI: 10.31031/TTEH.2021.03.000553.
  9. Žagar M, Klapan I, Mutka A, Majhen Z. Implementation Details for Controlling Contactless 3D Virtual Endoscopy. Appl Sci, 2022; 12: 1-10
  10. Žagar M, Klapan I, Mutka A, Majhen Z. Implementation Details for Controlling Contactless 3D Virtual Endoscopy. MDPI, 2022; 12(11): 5757.
  11. Klapan I, Žagar M, Majhen Z, Klapan L, Trampuš Z, Kostelac M, Berlengi N, Zemba M, Ljubičić A, Ešler M. Do we have "biomechanics" of the new era in our personalized contactless hand-gesture non-invasive surgeon-computer interaction? J Medical Systems (CC), 2023 (priprema za ob;  2023-2024;IF: 5,2)
  12. Žagar I, Klapan I, Mutka A, Majhen M, Klapan L, Trampuš Z, Ešler M. Computer assisted 3D-image-guided navigation with touchless gesture user interface during minimally invasive surgery of the head and neck. Health Informatics (CAS, CABI, Web of Science, Pubmed, Pubmed Central), Downloads/article: 3639.1 ; h5-index: 21; Citations/article: 8.4 (priprema za objavu; 2023-2024)
  13. Klapan I, Žagar M, Majhen Z, Klapan L, Trampuš Z, Kostelac M, Berlengi N, Zemba M, Ljubičić A, Ešler M. Do we have "biomechanics" of the new era in our personalized contactless hand-gesture non-invasive surgeon-computer interaction? J Medical Systems (CC), 2025. (submitted for publication)
  14. Jurlina M, Klapan I, Šercer M, Raos P.  Personalizede 3D PEEK implants in cranial bone reconstruction-a new clinical perspective. Am J ORL (submitted for publication), 2025.
  15. Trampuš Z, Trampuš M, Klapan I, Jurlina M, Raos P. Complex implant-prosthetic rehabilitations: innovative CRISTA method for embedding zygomatic implants in atrophic upper jaws. Am J ORL (submitted for publicationI), 2025.
  16. Klapan I, Žagar I, Demarin V, Klapan K, Mutka A, Majhen Z. Addressing surgeon fatigue and cognitive bias in the context of 3D-contactless surgery. Lancet Digital Health (submitted for publication), 2025.