Computer-Assisted Navigation in Brain Tumor Surgery

Abstract

Despite a great advancements in brain tumor diagnosis and surgery, a precise intraoperative location and removal of the neoplasmatic tissue remains difficult in many patients. For these reasons different navigation systems were developed. For the last several years neuronavigation has become widely used in brain tumor surgery. Surgical removal remains difficult in patients with small and deep seated brain lesions, multiple tumors, or location in important functional areas of the brain. Neurosurgeon faces the problem of causing severe neurological deficit as well as can have problems with finding and removing the lesion. Use of key hole procedures and surgical microscopes minimizes an operation field what forces to have a perfect orientation in the operation area, as well as precise data about the actual position of the instruments and their distance from the lesion. GOAL AND PURPOSE: Basing on their own surgical experience of 30 patients with brain tumors, the authors show the advantages and limitations of neuronavigation in surgical removal of brain tumors. MATERIAL AND METHODS: 30 patients with brain tumors located deeply in the hemispheres, skull and posterior fossa were analyzed. All patients were treated surgically with the use of neuronavigation equipment (Stryker Intellect Cranial Navigation System). Microsurgical technique with the use of magnification was introduced in all patients. After surgery, controlled CT examinations were performed in order to check the extension of tumor removal. RESULTS: Total surgical removal had been achieved in all patients. In all but one clinical result was excellent, the last patient died 2 weeks after removal of giant hypophyseal adenoma because of heart failure. CONCLUSIONS: Neuronavigation is an easy to use system which brings efficiency to surgical procedures. It allows to get a proper orientation in the operation field resulting in safe and accurate removal of intracranial neoplasms.