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Contour-guided brain tumor surgery using a stereotactic navigating microscope.

K Roessler·K Ungersboeck·T Czech·M Aichholzer·W Dietrich·H Goerzer·C Matula·W T Koos
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Abstract

OBJECTIVE: The benefit of intraoperative radiological data integration in approach planning and resection of brain tumors using a computer navigating microscope (MKM Zeiss) was investigated. METHODS: Since February 1995, out of 86 MKM-guided surgical procedures, 53 contour-guided tumor cases (24 females, 29 males, mean age 51.6) including 16 metastasis, 14 glioblastomas, 10 low-grade gliomas, 6 anaplastic gliomas, 3 meningiomas and 4 others were performed. The preoperative planning was based on CT in 42 cases and Magnetic Resonance Tomography (MRT) in 11 cases using skin markers (4-9, mean 6). Neuroradiologically defined tumor contours were transferred into the ocular of the microscope and projected into the operating field during the procedure. RESULTS: The advantages of the system were: (1) preoperative approach planning; (2) minimal, accurate skin incision and craniotomy; (3) intraoperative detection of deep seated lesions or lesion components; (4) determination of lesion boundaries; (5) minimized traumatization in/near eloquent areas. Mean registration accuracy improved from 5.3 mm for the first 10 cases up to 2 mm for the last 18 cases. In glioma surgery, the system provided exact definition of radiologically planned resection borders. In meningioma surgery, it allowed a tailored craniotomy, dura opening and resection, lowering the risk of recurrence. In metastasis surgery, it provided a safe approach to deep and eloquent located lesions. CONCLUSION: Contour-guided operation planning and resection guidance using the investigated navigating microscope provides additional security to avoid some potential risks in brain tumor surgery.

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AdultAstrocytomaBrain NeoplasmsFemaleGlioblastomaGliomaHumansImage Processing, Computer-AssistedIntraoperative CareMagnetic Resonance ImagingMaleMeningiomaMicroscopyMicrosurgeryMiddle AgedNeurosurgeryStereotaxic TechniquesTomography, X-Ray ComputedJournal Article

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K Roessler, K Ungersboeck, T Czech, M Aichholzer, W Dietrich, H Goerzer, C Matula, W T Koos. 1997. Contour-guided brain tumor surgery using a stereotactic navigating microscope.. https://doi.org/10.1159/000099899

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