The evolution of stereotactic guidance in neuroendoscopy.

Abstract

To evaluate the advantages and limitations of the utilized system in accordance with the operative indications of stereotactic neuroendoscopy. We reviewed our collective experience of computer-assisted stereotaxy (frame-based and frameless) and virtual endoscopy in neuroendoscopic surgery from 1982 to 2003. Sterotactic guiding systems (frame-based and frameless) have been used to perform more than 450 neuroendoscopic operations at our institute. Even though image guidance is not essential in all cases, technological developments have definitely been one of the major factors in improving outcomes. Planning endoscopic trajectory and intraoperative orientation within the ventricular system or other cavities are the main indications for its application. No surgical tool, no matter how accurate, can be a substitute for thoughtful and methodical pre-operative planning. Image-guided technologies are applied in order to make endoscopic surgery safer, faster and more easily reproducible. Despite the high initial cost of the equipment, overall expenses are expected to be reduced because of greater operative efficiency and shorter hospital stay.