Abstract
Surgical freedom is the most important metric at the disposal of the surgeon. The volume of surgical freedom (VSF) is a new methodology that produces an optimal qualitative and quantitative representation of an access corridor and provides the surgeon with an anatomical, spatially accurate, and clinically applicable metric. In this study, illustrative dissection examples were completed using two of the most common surgical approaches, the pterional craniotomy and the supraorbital craniotomy. The VSF methodology models the surgical corridor as a cone with an irregular base. The measurement data are fitted to the cone model, and from these fitted data, the volume of the cone is calculated as a volumetric measurement of the surgical corridor. A normalized VSF compensates for inaccurate measurements that may occur as a result of dependence on probe length during data acquisition and provides a fixed reference metric that is applicable across studies. The VSF compensates for multiple inaccuracies in the practical and mathematical methods currently used for quantitative assessment, thereby enabling the production of 3-dimensional models of the surgical corridor. The VSF is therefore an improved standard for assessment of surgical freedom.
Highlights
Importance of Quantitative AnatomyAnatomy is the foundation of medical understanding
This methodology generated two useful products: a mathematically robust quantitation of the surgical freedom of a neurosurgery instrument and a 3D spatially accurate model of the surgical corridor that takes into account irregular neuroanatomical parameters
This process gives direct quantitative information to allow for the comparison of surgical approaches
Summary
Anatomy is the foundation of medical understanding. Medical practice has evolved through the continual scrutiny of biological structure and physiologic function (Acar et al, 2005; Elhadi et al, 2012; Arraez-Aybar et al, 2015). As the merits of anatomical scrutiny in disease therapy were elucidated, the drive to be able to discriminate between “normal” and “abnormal” biological arrangement increased. This development resulted in the advent of quantitative anatomical research, the objective of which was to measure the complexity of human architecture.
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