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Multiple brain tumor nodule resections under direct visualization of a neuronavigated endoscope
X Di1
1Section of Pediatric and Congenital Neurosurgery, Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, OH 44195, USA. dix@ccf.org
Minimally Invasive Neurosurgery : MIN
|October 20, 2007
Summary
This study introduces a navigated endoscope technique for brain tumor resection, enabling simultaneous 3D visualization and direct endoscopic guidance for minimally invasive surgery, especially for multiple lesions.
Area of Science:
- Neurosurgery
- Medical Imaging
- Minimally Invasive Surgery
Background:
- Endoscopic neurosurgery offers advantages but traditional neuronavigation requires frequent tool switching.
- Current methods can be cumbersome, necessitating improvements for seamless intraoperative guidance.
Purpose of the Study:
- To describe and report on the application of image-guided endoscopy as a sole optical and navigation device.
- To evaluate the technique in two cases of multiple intracranial tumor nodules.
Main Methods:
- Utilized a 0-degree, 4-mm rigid endoscope integrated with a neuronavigation system (Voyager SX).
- Calibrated the endoscope as a virtual wand for real-time targeting and visualization.
- Employed virtual endoscopy for entry point identification and 3D rendered MR images for trajectory guidance.
Main Results:
- Successfully resected multiple tumor nodules (three in one patient, two in another) using the navigated endoscope.
- Achieved tumor removal directly under simultaneous navigated-endoscopic visualization and 3D imaging guidance.
- Performed procedures with a minimal 3-cm linear skin incision at the navigated entry point.
Conclusions:
- The neuronavigated endoscope provides simultaneous 3D orientation and direct visualization.
- This technique offers a unique advantage for solely endoscopic minimally invasive procedures.
- It is particularly beneficial for resecting multiple intracranial lesions.
