Keyhole Brain Surgery without Neuronavigation: Innovative Usage of Limited Available Resources

Area of Science:

• Neurosurgery
• Medical Imaging
• Minimally Invasive Procedures

Background:

• Neurosurgical techniques have advanced towards minimally invasive approaches using modern imaging.
• Keyhole surgery offers reduced trauma but requires precise preoperative planning.
• Traditional navigation systems can be costly and inaccessible in resource-limited settings.

Purpose of the Study:

• To evaluate the efficacy of open-source Digital Imaging and Communications in Medicine (DICOM) software for preoperative planning in keyhole neurosurgery.
• To compare outcomes of keyhole surgery planned with DICOM software versus conventional methods.
• To assess the utility of DICOM software in resource-limited environments.

Main Methods:

• Retrospective analysis of 176 patients undergoing keyhole procedures with DICOM software.
• Comparison with a control group of 172 matched patients.
• Utilized high-resolution MRI and CT scans for 3D reconstruction and interactive planning with DICOM software.

Main Results:

• Keyhole surgery with DICOM planning resulted in significantly smaller incisions (50 vs. 200 mm) and craniotomies (9 vs. 120 cm²).
• Operative time was reduced (140 vs. 345 minutes) with fewer wound complications (3 vs. 21).
• Statistical significance (p < 0.001) was observed across key outcome measures.

Conclusions:

• Accessible open-source DICOM software effectively supports keyhole neurosurgery and minimally invasive techniques.
• This method enhances surgical precision and improves patient outcomes by reducing trauma and recovery time.
• It is particularly valuable for resource-limited settings lacking traditional navigation systems.