Onscreen‐guided resection of extra‐axial and intra‐axial forebrain masses through registration of a variable‐suction tissue resection device with a neuronavigation system

2020 ◽  
Vol 49 (4) ◽  
pp. 676-684
Author(s):  
Rebecca A. Packer ◽  
Stephanie McGrath
Keyword(s):  
Neuronavigation System ◽  
Variable Suction

scholarly journals A Simple Method to Avoid Brain Shift during Neuronavigation: Technical Note

2020 ◽  
Author(s):  
Jair Leopoldo Raso
Keyword(s):  
Dura Mater ◽  
Brain Area ◽  
Conventional Technique ◽  
Technical Note ◽  
Cortical Surface ◽  
Brain Shift ◽  
Simple Method ◽  
Cortex Area ◽  
Neuronavigation System ◽  
The Brain

Abstract Introduction The precise identification of anatomical structures and lesions in the brain is the main objective of neuronavigation systems. Brain shift, displacement of the brain after opening the cisterns and draining cerebrospinal fluid, is one of the limitations of such systems. Objective To describe a simple method to avoid brain shift in craniotomies for subcortical lesions. Method We used the surgical technique hereby described in five patients with subcortical neoplasms. We performed the neuronavigation-guided craniotomies with the conventional technique. After opening the dura and exposing the cortical surface, we placed two or three arachnoid anchoring sutures to the dura mater, close to the edges of the exposed cortical surface. We placed these anchoring sutures under microscopy, using a 6–0 mononylon wire. With this technique, the cortex surface was kept close to the dura mater, minimizing its displacement during the approach to the subcortical lesion. In these five cases we operated, the cortical surface remained close to the dura, anchored by the arachnoid sutures. All the lesions were located with a good correlation between the handpiece tip inserted in the desired brain area and the display on the navigation system. Conclusion Arachnoid anchoring sutures to the dura mater on the edges of the cortex area exposed by craniotomy constitute a simple method to minimize brain displacement (brain-shift) in craniotomies for subcortical injuries, optimizing the use of the neuronavigation system.

scholarly journals MS-2 Minimally invasive glioma surgery with navigation system and tubular retractor

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii2-ii3
Author(s):  
Kazuhiko Kurozumi
Keyword(s):  
Navigation System ◽  
Diffusion Tensor ◽  
Therapeutic Option ◽  
Normal Brain ◽  
Navigation Systems ◽  
Glioma Surgery ◽  
Tubular Retractor ◽  
Neuronavigation System ◽  
Magnetic Resonance Imaging Mri ◽  
Neurological Surgery

Abstract Navigation systems are reliable and safe for neurological surgery. Navigation is an attractive and innovative therapeutic option. Recently, endo and exoscopic surgeries have been gradually increasing in neurosurgery. We are currently trialing to use 4K and 8K systems to improve the accuracy and safety of our surgical procedures. Surgeries for deep-seated tumors are challenging because of the difficulty in creating a corridor and observing the interface between lesions and the normal area. In total, 315 patients underwent surgery at Okayama University between 2017 and 2019. Among them, we experienced 92 glioma surgeries using navigation systems. Preoperatively, we performed computed tomography imaging and contrast-enhanced magnetic resonance imaging (MRI) for the neuronavigation system. We experienced Curve(TM) Image Guided Surgery (BrainLab, Munich, Germany). The surgical trajectory was planned with functional MRI and diffusion tensor imaging to protect the eloquent area and critical vasculature of the brain. We used a clear plastic tubular retractor system, the ViewSite Brain Access System, for surgery of deep seated gliomas. We gently inserted and placed the ViewSite using the neuronavigation. The tumor was observed and resected through the ViewSite tubular retractor under a microscope and endoscope. If the tumor was large, we switched the ViewSite tubular retractor to brain spatulas to identify the boundary between the normal brain and lesion. We are currently using the combination of the tubular retractor and brain spatulas using navigation system. Here, we present and analyze our preoperative simulation, surgical procedure, and outcomes.

Integrating Magnetic Resonance Imaging Postprocessing Results into Neuronavigation for Electrode Implantation and Resection of Subtle Focal Cortical Dysplasia in Previously Cryptogenic Epilepsy

Neurosurgery ◽  
2010 ◽  
Vol 66 (1) ◽  
pp. 187-195 ◽  
Author(s):  
Jörg Wellmer ◽  
Yaroslav Parpaley ◽  
Marec von Lehe ◽  
Hans-Jürgen Huppertz
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Morphometric Analysis ◽  
Region Of Interest ◽  
Normal Database ◽  
Resonance Imaging ◽  
Electrode Implantation ◽  
Neuronavigation System ◽  
The Individual

Abstract OBJECTIVE Focal cortical dysplasias (FCDs) are highly epileptogenic lesions. Surgical removal is frequently the best treatment option for pharmacoresistant epilepsy. However, subtle FCDs may remain undetected even after high-resolution magnetic resonance imaging (MRI). Morphometric MRI analysis, which compares the individual brain with a normal database, can facilitate the detection of FCDs. We describe how the results of normal database–based MRI postprocessing can be used to guide stereotactic electrode implantation and subsequent resection of lesions that are suspected to be FCDs. METHODS A presurgical evaluation was conducted on a 19-year-old woman with pharmacoresistant hypermotor seizures. Conventional high-resolution MRI was classified as negative for epileptogenic lesions. However, morphometric analysis of the spatially normalized MRI revealed abnormal gyration and blurring of the gray-white matter junction, which was suggestive of a small and deeply seated FCD in the left frontal lobe. RESULTS The brain region highlighted by morphometric analysis was marked as a region of interest, transferred back to the original dimension of the individual MRI, and imported into a neuronavigation system. This allowed the region of interest–targeted stereotactic implantation of 2 depth electrodes, by which seizure onset was confirmed in the lesion. The electrodes also guided the final resection, which rendered the patient seizure-free. The lesion was histologically classified as FCD Palmini and Lüders IIB. CONCLUSION Transferring normal database–based MRI postprocessing results into a neuronavigation system is a new and worthwhile extension of multimodal neuronavigation. The combination of resulting regions of interest with functional and anatomic data may facilitate planning of electrode implantation for invasive electroencephalographic recordings and the final resection of small or deeply seated FCDs.

scholarly journals Neurosurgery and brain shift: review of the state of the art and main contributions of robotics

TecnoLógicas ◽  
2017 ◽  
Vol 20 (40) ◽  
pp. 125-138
Author(s):  
Karin Correa-Arana ◽  
Oscar A. Vivas-Albán ◽  
José M. Sabater-Navarro
Keyword(s):  
Brain Tumor ◽  
State Of The Art ◽  
Image Guided Surgery ◽  
Medical Procedures ◽  
Brain Shift ◽  
Future Perspectives ◽  
Guided Surgery ◽  
Image Guided ◽  
Neuronavigation System ◽  
Minimal Invasion

This paper presents a review about neurosurgery, robotic assistants in this type of procedure, and the approach to the problem of brain tissue displacement, including techniques for obtaining medical images. It is especially focused on the phenomenon of brain displacement, commonly known as brain shift, which causes a loss of reference between the preoperative images and the volumes to be treated during image-guided surgery. Hypothetically, with brain shift prediction and correction for the neuronavigation system, minimal invasion trajectories could be planned and shortened. This would reduce damage to functional tissues and possibly lower the morbidity and mortality in delicate and demanding medical procedures such as the removal of a brain tumor. This paper also mentions other issues associated with neurosurgery and shows the way robotized systems have helped solve these problems. Finally, it highlights the future perspectives of neurosurgery, a branch of medicine that seeks to treat the ailments of the main organ of the human body from the perspective of many disciplines.

scholarly journals NS-06IMAGE GUIDED SURGERY USING NEURONAVIGATION SYSTEM IN RESECTION OF CEREBRAL GLIOMAS INVOLVING ELOQUENT CORTICAL AREAS IN PEDIATRIC POPULATION

2016 ◽  
Vol 18 (suppl 3) ◽  
pp. iii128.2-iii128 ◽  
Author(s):  
Afsoun Seddighi ◽  
Amir Saied Seddighi ◽  
Amir Nikouei ◽  
Gholamreza Mohseni
Keyword(s):  
Pediatric Population ◽  
Guided Surgery ◽  
Cortical Areas ◽  
Cerebral Gliomas ◽  
Neuronavigation System
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