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[Stereotactic Biopsy in the Lateral Position Using a Neuronavigation System].

Kenji Yoshiki1, Masashi Kinoshita, Shingo Tanaka

  • 1Department of Neurosurgery, Kanazawa University.

No Shinkei Geka. Neurological Surgery
|November 1, 2019
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Summary

The lateral position offers a safer approach for stereotactic brain biopsy under local anesthesia compared to the supine position. This method ensures stable breathing and accessibility for improved patient outcomes.

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Area of Science:

  • Neurosurgery
  • Minimally Invasive Procedures
  • Neurological Diagnostics

Background:

  • Stereotactic brain biopsy under local anesthesia is minimally invasive but faces challenges with tumor accessibility and airway stability.
  • Sedation can lead to airway instability during stereotactic brain biopsy.

Purpose of the Study:

  • To compare the safety and surgical efficiency of stereotactic brain biopsy in supine versus lateral positions.
  • To evaluate tumor localization, operative time, and intraoperative difficulties between the two positions.

Main Methods:

  • A comparative study of 25 navigation-guided brain biopsies performed in supine and lateral positions.
  • Analysis of tumor localization, operation time, standby time, intraoperative difficulties, and diagnostic yield.
  • 3D visualization of biopsy trajectories to assess puncture sites.

Main Results:

  • Tumor biopsies were feasible in all cerebral lobes using the lateral position.
  • No significant differences in operation or standby times were observed between supine and lateral positions.
  • The lateral position facilitated stable breathing and eliminated the need for additional sedation due to patient movement, achieving a 100% final diagnosis rate.

Conclusions:

  • Stereotactic brain biopsy in the lateral position is a safer and more effective alternative to the supine position.
  • The lateral position enhances patient safety and procedural stability during local anesthesia.