Sonography or ultrasound is the use of ultrasound as an imaging method for diagnostic purposes and visual inspection in therapeutic interventions. The greatest advantage of sonography is certainly the complete harmlessness of diagnostic ultrasound waves, especially in comparison to x-ray procedures, which can often be associated with a high radiation load for the patient. Significant information enhancement (visualization of tissues) compared to other imaging procedures (MRI, CT, X-ray) a dynamic, function evaluation more detailed visualization, reduced technical effort and ease of access.

The ever-faster development of today’s sonography offers an ever-more sophisticated image quality with respect to image clarity, resolution and the possibility of distinguishing between tissue types and structures.

This excellent image quality now allows the visualization of tissue structures in the body, which were previously not detectable by means of sonography, such as ultrasound analysis or precise spinal canal or epidural imaging.

The image resolution of today’s sonography has thus gained in visual, image contrasts and depth of the visible tissue structures, so that the range of applications for sonography has significantly expanded for the medical fields.

Particularly in orthopedics, accident surgery, neuro-surgery, intensive neurosurgery and regional anesthesia, the optical requirements and the increased use of sonography are to be found here.

Sonography can represent the most diverse tissue structures much more accurately and more securely than by the commonly used methods such as radiography, MRI, CT.

Most imaging methods provide static images. Using ultrasound, you can create “moving images” for movement sequences for the functional assessment of tissues and structures. Movable images are also possible for video recordings and also for visual inspection of the overall movement of the instruments during the course of the operation.

Thus a dynamic examination and visual inspection with representation of structures of all tissues in different body parts in real time is possible.

Nowadays, sonography is used not only for diagnosis, but also for intra-operative therapeutic use to control the operation, i.e. to perform surgery under ultrasound.

During the surgical procedure – particularly in the micro-therapeutic field – the image presentation of the sonography is particularly important for the safe orientation and the ongoing control of the surgical instruments used.

In the reverse sense, this means that without the imaging of the sonography, many surgical procedures – particularly in the micro-therapeutic area – would not be possible or very severely restricted.

With the today`s practice of freehand realized Sonography-intervention or Sonography-control, exist the following disadvantages:

First, a surgeon’s hand is always occupied with the ultrasonic head probe and permanently busy with the post-correction to create and maintain a qualified, sonographic image. This is done with simultaneous, constant monitoring of the monitor on which the sonographic images are displayed.

Secondly, the continuous visual inspection (in the sound width of micro-dimensions) of the manually guided ultrasonic head means a tremendous strain on the surgeon who must simultaneously focus on two instruments: the ultrasonic head and the surgical instrument.

Such uncertainties and complex processes have hitherto prevented the intra-operative use of the ultrasound in difficult interventions, and the clear advantages of the ultrasound visualization which is superior today are obviously not used for intra-operative interventions.

From this years of experience, the Sono Control Arm™ has been developed by Prof. Babayan with a special holder for the ultrasound head, which is highly mobile for the most varied areas of operation in the OP in flowing, easy movements and at the same time with maximum precision in every position. Furthermore, with a handle it is securely fixable in order not to lose the sound layer of the ultrasound imaging.

The surgeon thus has both hands free and is relieved from the internal tension, which entails constant manual guidance and visual inspection of the ultrasound head. Instead, the operator can concentrate all his attention on the operation and the instrumental use.
A further advantage of the Sono Control Arm™ is the fundamental safety of maintaining a desired position and imaging of the ultrasound head – especially during surgery, which can hardly be ensured by handholding in this exact position over an extended period of time.

This method of operation and use of the Sono Control Arm™ also allows much more complicated surgical procedures to be performed than hitherto possible.

Thanks to this Sono Control Arm™ device, the valuable and qualified imaging of the ultrasound can be used optimally intra-operatively in order to perform much more precise and safe interventions, whereby the secure ultrasound head guidance is achievable in 0.1 mm dimensions.

The sonography, applied by the Sono Control Arm™ safely, is a very crucial aid to realize under precise visual inspection:

  • the planning of the operations accesses and
  • the performance of the operations or
  • the introduction of an endoscope

and the entire operating sequence without the risk of uncontrollably violating important tissue structures or organs.

According to the present state of the art, such interventions are carried out using a permanent X-ray control, which can have a harmful radiation exposure for the patient. The X-ray-based visualization also has the great disadvantage of the not possible representation of numerous tissues and organs (nerves, vessels, musculature, tendons, ligaments, volume, and parenchymatous organs, cartilage). Which is the prerequisite for an accurate and safe execution of an intervention.

Due to the optimal use of the sonography by the targeted use of the Sono Control Arm, the micro-therapeutic MIBRAR® method can safely and successfully perform all joint or spinal surgery operations without having to open the body and still with complete visual inspection.

This technical advancement is the prerequisite for performing an ankle or spinal surgery with the aid of the MIBRAR® method without the usual anesthesia and the usual operating expenditure with hospital stay.

The safe imaging of sonography using the Sono Control Arm™ and the MIBRAR® method has many advantages:

  • There is no radiation exposure to the patient due to intra-operative imaging instruments such as image transducer / X-ray / C-arm.
  • The microinvasive procedure according to the MIBRAR® method is enormously time-saving, so that the overall procedure is less stressful for the patient.
  • The time saving with the use of the microinvasive MIBRAR® method and the help of modern sonography makes it possible to carry out more complex and complex procedures in the joint or spinal area.

These interventions are carried out as efficiently and gently as possible in a wide range of areas, such as e.g.:

  • for intra-spinal interventions in the spinal canal,
  • for intervertebral discs
  • or in microinvasive interventions on joints, e.g. the microinvasive arthroscopy.

This innovation revolutionizes today’s existing worldwide surgery.

The MIBRAR® system