Image Guided Stereotactic Surgery

What is image guided stereotactic neurosurgery?

Image-guided surgery has been employed in neurosurgery since the mid-1990s. This equipment falls under the category of "Minimally Invasive Surgery" (MIS). This new technique relies on a powerful computer system, which assists the surgeon in precisely localizing a lesion, in planning each step of the procedure via a 3D model on the computer screen, and in calculating the ideal access to the target (for example, a tumor) before the operation. The tumor and its surroundings can be viewed from different angles and in relation to landmark structures, such as the optic nerve or the brain stem. During the operating procedure, the movement of the instruments in use inside the brain can be tracked on the monitor with a precision of 1-2 millimeters, through which damage to healthy tissue and to critical areas can be avoided as much as possible.

You might compare image-guided surgery to the location and directional tracking systems used for cars and ships today -- it is, in effect, a GPS system for the neurosurgeon. After the computer has been fed the CT and/or MRI imaging data of the patient, it will construct 3D or 2D images in any plane requested. It then, superimposes the position of the instruments as they are used in surgery onto images of the anatomy displayed on a monitor. Much as the driver of a car uses the GPS system to find the way on the road, the neurosurgeon depends on these images to confirm the position of his or her instruments in the patient's body.

The image-guided surgery (IGS) infrared camera works a lot like the satellite that detects signals from cars, boats, and other vehicles equipped with special tracking devices. As the surgeon moves an instrument in the body, the IGS camera, recalculates its position, and then transfers that data to a computer in the operating room. The computer then shows the direction the instrument is moving relative to its surroundings.

To accomplish this, the computer must have constant feed back as to where you are with reference to a known location. The computer is given the digital information for every point in the head, reconstructs two or three dimensional images of what the brain looks like, and with continuous feed back from infrared light beams, corrects for any changes as they occur. In other words, the computer "shows" us where the instruments are and exactly how close we are to important surrounding structures. The technology is used for both cranial and spine surgery.

Using these state-of-the-art image reconstruction tools and 3-D rendering, we are now able to simulate surgery prior to the actual procedure, and refine our technique during surgery. The safest, least invasive approach can now be planned prior to the operation. This minimally invasive technique is costly and takes additional time, but the results are well worth it.

Image Guided Stereotactic Surgery aides in the surgery of:

• Brain Tumors
• Hydrocephalus
• Brain Cysts
• Stereotactic Biopsy
• Brain Infections
• Spine Tumors
• Spinal Fusion
• Spinal Reconstruction
• Disc Herniations