Articles: neuronavigation.
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Accurate neuro-registration is important as the success of the surgical procedure highly depends on it. This article deals with neuro-registration using tele-manipulation (Master-Slave Manipulation) to facilitate tele-surgery and enhance the overall accuracy and reach of the robot-assisted neurosurgery. ⋯ Accurate neuro-registration using tele-manipulation has been demonstrated. The overall accuracy of the robot-based neurosurgery is tabulated. This approach eliminates line-of-sight issue and the requirement of an additional unit for neuro-registration. This minimizes the registration time and makes intraoperative registration feasible.
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Journal of neurosurgery · Dec 2024
Turning the operating room into a mixed-reality environment: a prospective clinical investigation for cerebral aneurysm clipping.
The overall aim of this study was to demonstrate the potential benefit of a novel mixed-reality-head-mounted display (MR-HMD) on the spatial orientation of surgeons. ⋯ The incorporation of mixed reality in neurosurgical operations marks a significant advancement in the field. The use of mixed reality in brain surgery enhances the spatial awareness of surgeons, enabling more instinctive and precise surgical interventions. This technological integration promises to refine the execution of complex procedures without compromising accuracy.
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Journal of neurosurgery · Dec 2024
Brain tumor surgery guided by navigated transcranial magnetic stimulation mapping for arithmetic calculation.
The onco-functional balance represents the primary goal in neuro-oncology. The increasing use of navigated transcranial magnetic stimulation (nTMS) allows the noninvasive characterization of cortical functional anatomy, and its reliability for motor and language mapping has previously been validated. Calculation and arithmetic processing has not been studied with nTMS so far. In this study, the authors present their preliminary data concerning nTMS calculation. ⋯ Based on the authors' preliminary data, nTMS can be an advantageous tool to study cognitive functions, aimed at minimizing neurological impairment. The postoperative clinical outcome for patients who underwent operation with nTMS was very good. Considering these results, nTMS has proved to be a feasible method to map cognitive areas including those for calculation functions. Further analyses are needed to validate these data. Finally, other cognitive functions (e.g., visuospatial) may be explored with nTMS.
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Comparative Study
Neuronavigation combined with intraoperative ultrasound and intraoperative magnetic resonance imaging vs neuronavigation alone in diffuse glioma surgery.
This study aimed to integrate intraoperative ultrasound and magnetic resonance imaging (IMRI) with neuronavigation (NN) to create a multimodal surgical protocol for diffuse gliomas. Clinical outcomes were compared to the standard NN-guided protocol. ⋯ Compared to standard NN-guided surgery, multimodal-integrated surgery using NN, IMRI, and intraoperative ultrasound significantly increased the EOR and GTR rates for diffuse gliomas.
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The Stealth Autoguide (Medtronic, Minneapolis, MN) is a robotic auto-targeting device for stereotactic brain biopsy, placement of stereoelectroencephalography electrodes, and laser ablation therapy. This paper evaluates its off-label application as robotic endoscope holder in transnasal and intraventricular neurosurgery. The potential to enhance stability, reduce manual adjustments, and improve surgical precision is discussed, alongside cost-effectiveness and feasibility. ⋯ This experience proves that the Stealth Autoguide can be safely and effectively used as a robotic support for endoscopic procedures. This device ensures precise positioning and manipulation of neuroendoscopes, facilitating visualization and targeting of the desired area. Further researches are needed to verify applications and limitations.