ABSTRACT
Neurosurgery guided by intraoperative ultrasound imaging is presented. The method is based on a stereotactic handfree ultrasound imaging device, designed to monitor cerebral shifts and lesion volume modifications during surgery. Preoperative CT and MR, acquired within a reference system, merge with ultrasound images stereotactically obtained by means of a lockable articulated encoded support. Landmarks from the lesion and surrounding structures are identified prior to opening of the dura and used during surgery to monitor volume changes.
Subject(s)
Brain/anatomy & histology , Brain/surgery , Intraoperative Care/instrumentation , Stereotaxic Techniques/instrumentation , Ultrasonography/instrumentation , Brain Mapping , Humans , Magnetic Resonance Imaging , Neurosurgery/methods , Preoperative Care , Tomography, X-Ray Computed , TransducersABSTRACT
We describe the implementation of a robotic arm connected to a neurosurgical operative microscope. A force feedback sensor drives the motors of the arm in response to the positioning of the microscope by the surgeon. Computer graphic techniques allow tracking of the current position of the microscope within the volumetric reconstruction of the brain. The integration of the prototype into the neurosurgical operating room is currently being evaluated. Preliminary comments on this experimental phase are offered.
Subject(s)
Microsurgery/instrumentation , Neurosurgery/instrumentation , Robotics , Angiography, Digital Subtraction , Computer Graphics , Humans , Image Processing, Computer-Assisted , Magnetic Resonance Imaging , Minimally Invasive Surgical Procedures , Stereotaxic Techniques , Tomography, X-Ray ComputedABSTRACT
A computer assisted toolholder, integrated with an anatomical graphic 3-D rendering programme, is presented. Stereotactic neuroanatomical images are acquired, and the same reference system is employed to represent the position of the toolholder on the monitor. The surgeon can check the orientation of different approach trajectories, moving the toolholder in a situation of virtual reality. Angular values expressed by high precision encoders on the five joints of the toolholder modify "on line" the representation of the configuration of the toolholder within the three dimensional representation of the patient's anatomy.
Subject(s)
Artificial Intelligence , Image Processing, Computer-Assisted/instrumentation , Robotics/instrumentation , Stereotaxic Techniques/instrumentation , Computer Graphics/instrumentation , Equipment Design , Expert Systems/instrumentation , Humans , Microsurgery/instrumentation , Tomography, X-Ray Computed/instrumentationABSTRACT
A computer controlled mechanical arm for stereotaxy is presented. It has 5 free joints and can be attached to a stereotactic frame. High precision digital encoders register the angular position of each joint and the computer determines the position of the tip of the instrument in the stereotactic space. Accuracy and usefulness are discussed.
Subject(s)
Computers/statistics & numerical data , Equipment Design , Stereotaxic Techniques , Brain/pathology , Brain/surgery , Brain Neoplasms/pathology , Brain Neoplasms/surgery , Female , Humans , Male , RadiosurgeryABSTRACT
Stereotactic acquisition of neuroradiological data, followed by identification of cerebral structures and three-dimensional rendering, has been successfully applied to guided microsurgical resection of deep-seated cerebral lesions. The method described utilizes data from magnetic resonance, computed tomography, and digital angiography and allows the surgeon to 'wire frame' the lesion volume and the position of cerebral vessels and structures of high functional relevance. Three-dimensional rendering of surgical instrumentation around the reconstructed anatomy allows for planning and simulation of the trajectory of approach.
