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Related Experiment Video

Updated: Oct 26, 2025

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Augmented reality navigation for cranial biopsy and external ventricular drain insertion.

Simon Skyrman1, Marco Lai2,3, Erik Edström1

  • 11Department of Neurosurgery, Karolinska University Hospital, and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Neurosurgical Focus
|August 1, 2021
PubMed
Summary

This study shows augmented reality surgical navigation (ARSN) is accurate and efficient for guiding biopsy needles and external ventricular drains (EVDs) in neurosurgery. The ARSN system achieved high precision in phantom models for these critical procedures.

Keywords:
augmented realitybrain biopsyexternal ventricular drainageimage-guided surgeryneurosurgerysurgical navigation

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Area of Science:

  • Neurosurgery
  • Medical Imaging
  • Surgical Navigation

Background:

  • Neurosurgical procedures like biopsies and EVD insertions demand high precision.
  • Traditional navigation methods may have limitations in accuracy and real-time guidance.

Purpose of the Study:

  • To evaluate the accuracy and efficacy of an augmented reality surgical navigation (ARSN) system.
  • To assess ARSN for guiding biopsy needles and external ventricular drains (EVDs) in neurosurgery.

Main Methods:

  • A hybrid operating room-based ARSN system with robotic C-arm, intraoperative cone-beam CT (CBCT), and optical tracking was utilized.
  • A 3D-printed skull phantom with a brain model was used for 30 cranial biopsy and 10 EVD insertions.
  • Needle and device positions were verified using CBCT post-insertion.

Main Results:

  • Mean accuracy for biopsy needle insertions was 0.8 mm ± 0.43 mm, with a median insertion time of 149 seconds.
  • Mean accuracy for EVD insertions was 2.9 mm ± 0.8 mm at the tip, with a 0.7° ± 0.5° angular deviation.
  • Insertion times for EVDs were a median of 188 seconds.

Conclusions:

  • Augmented reality surgical navigation (ARSN) demonstrates high accuracy and efficacy for percutaneous cranial biopsies.
  • ARSN provides a viable and precise method for guiding external ventricular drain insertions.
  • The study validates ARSN as a valuable tool in neurosurgical navigation.