SURG-20. USE OF NICO MYRIAD NOVUS DEVICE WITH LIGHT SOURCE AND REAL-TIME STEREOTACTIC NAVIGATION TO OPTIMIZE SURGICAL RESECTION OF DEEP-SEATED TUMORS

Abstract

Abstract Maximal and safe surgical resection remains a critical component of the standard of care for patients with brain tumors. Stereotactic navigation tools are often incorporated into the surgical planning and implementation. The NICO Myriad NOVUS device couples a light source with the resecting tip to allow enhanced visualization of the surgical cavity and surrounding anatomical structures. At the Cleveland Clinic, we were the first group in the U.S. to start utilizing this augmented technology to maximize the resection of particularly deep-seated brain tumors, using the xenon light and real-time stereotactic navigation of the tool tip with the BrainLAB cranial setting. The navigated tip allows us to reach the deep corners of tumors with or without a tubular retracting device by sparing large corticotomies. Furthermore, the light source within the handheld device is easier to handle and manipulate than a large microscope to illuminate the surgical cavity. In addition, this new tool allows for automated tumor and peri-tumoral tissue harvesting, annotating each sample by location intraoperatively, as well as biological preservation of the harvested tissue for post-surgical molecular analysis. We describe the techniques and advantages of using this novel technology in patients while following and preliminarily reporting their surgical outcomes. With the emergence of novel technological advances, we must adapt as neurosurgeons and develop innovative methods to optimize the surgical resection of brain tumors.