Neurosurgical simulation and navigation with three-dimensional computer graphics

We developed a pre-operative simulation and intra-operative navigation system with three-dimensional computer graphics (3D-CG). Because the 3D-CG created by the present system enables visualization of lesions via semitransparent imaging of the scalp surface and brain, the expected operative field could be visualized on the computer display pre-operatively. We used two different configurative navigators. One is assembled by an arciform arm and a laser pointer. The arciform arm consists of 3 joints mounted with rotary encoders forming an iso-center system. The distal end of the arm has a laser pointer, which has a CCD for measurement of the distance between the outlet of the laser beam, and the position illuminated by the laser pointer. Using this navigator, surgeons could accurately estimate the trajectory to the target lesion, and the boundaries of the lesion. Because the other navigator has six degrees of freedom and an interchangeable probe shaped like a bayonet on its tip, it can be used in deep structures through narrow openings. Our system proved efficient and yielded an unobstructed view of deep structures during microscopic neurosurgical procedures.