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[Transsphenoidal surgery assisted by navigation system].

M Abe¹, H Udono, K Tabuchi

¹Department of Neurosurgery, Saga Medical School, 5-1-1 Nabeshima, Saga-city, Saga 849-8501, Japan.

No Shinkei Geka. Neurological Surgery

|February 24, 2001

Summary

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Neuronavigation systems enhance transsphenoidal surgery by precisely locating sellar lesions, improving tumor removal. While effective for guiding tumor margins and protecting critical structures, it has limitations in estimating residual tumor size.

Area of Science:

Neurosurgery
Medical Technology
Surgical Navigation

Context:

Transsphenoidal surgery is a minimally invasive approach for accessing sellar region lesions.
Accurate localization of tumors is crucial for effective surgical resection and minimizing complications.
Neuronavigation systems offer advanced visualization and guidance during complex surgical procedures.

Purpose:

To evaluate the utility and effectiveness of a neuronavigation system (optical tracking system - OTS) in assisting transsphenoidal surgeries for various sellar lesions.
To assess the impact of neuronavigation on tumor localization, extent of resection, and surgical guidance.

Summary:

Nineteen transsphenoidal surgeries for sellar lesions (pituitary adenomas, clival chordoma, Rathke's cleft cyst, suprasellar germinoma) utilized an optical tracking system (OTS) for neuronavigation.

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The system precisely localized tumors, aiding in the total removal of all five microadenomas and facilitating guidance to tumor margins and internal carotid arteries in macroadenomas.

The neuronavigation system particularly benefited the endonasal approach by providing a three-dimensional view, though it was less effective in estimating suprasellar residual tumor due to intraoperative dislocation.

Impact:

Neuronavigation significantly improves the precision of tumor localization and resection in transsphenoidal surgery.
The system enhances surgical safety by providing guidance to critical neurovascular structures like the internal carotid arteries.
While highly beneficial for intraoperative guidance, the current limitations in assessing residual tumor volume necessitate complementary methods for complete tumor removal assessment.