Image-guided surgery

Today, doctors are using computerized technologies that are familiar to people in the consumer world to help fight cancer in the operating room. An important example of that application is image guided surgery (IGS) and it helps surgeons perform safer and less invasive [1] procedures and remove brain tumors that were once considered inoperable due to their size and/or location.

Image-guided surgery is the general term used for any surgical procedure where the surgeon employs tracked surgical instruments in conjunction with preoperative or intraoperative images in order to indirectly guide the procedure. Similar to a car or mobile Global Positioning System (GPS), image guided surgery systems use cameras or electromagnetic fields to capture and relay the patient’s anatomy and the surgeon’s precise movements in relation to the patient, to computer monitors in the operating room. These sophisticated computerized systems, like Curve Image Guided Surgery, Kick Navigation and StealthStation are used before and during surgery to help orient the surgeon with three-dimensional images of the patient’s anatomy including the tumor.

The various applications of navigation for neurosurgery have been widely used and reported for almost two decades.[2] According to a study in 2000, researchers were already anticipating that a significant portion of neurosurgery would be performed using computer-based interventions.[3]

Part of the wider field of computer-assisted surgery, image-guided surgery can take place in hybrid operating rooms using intraoperative imaging. A hybrid operating room is a surgical theatre that is equipped with advanced medical imaging devices such as fixed C-Arms, CT scanners or MRI scanners. Most image-guided surgical procedures are minimally invasive. A field of medicine that pioneered and specializes in minimally invasive image-guided surgery is interventional radiology.

Image-guided surgery was originally developed for treatment of brain tumors using stereotactic surgery and radiosurgery that are guided by computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET) using a technology known as the N-localizer.[4][5][6][7][8][9][10][11][12][13][14] Image-guided surgery has found wide application in surgery of the sinuses, where it helps to avoid damage to brain and nervous system.

A hand-held surgical probe is an essential component of any image-guided surgery system. During the surgical procedure, the IGS tracks the probe position and displays the anatomy beneath it as, for example, three orthogonal image slices on a workstation-based 3D imaging system. Existing IGS systems use different tracking techniques including mechanical, optical, ultrasonic, and electromagnetic.

When fluorescence modality is adopted to such devices, the technique is also called fluorescence image-guided surgery.

References

  1. ↑
  2. ↑
  3. ↑ [Kelly PJ. What is past is prologue. Neurosurgery. 2000 Jan; 46(1):16-27.]
  4. ↑ Tse, VCK; Kalani, MYS; Adler, JR (2015). "Techniques of Stereotactic Localization". In Chin, LS; Regine, WF. Principles and Practice of Stereotactic Radiosurgery. New York: Springer. p. 28.
  5. ↑ Saleh, H; Kassas, B (2015). "Developing Stereotactic Frames for Cranial Treatment". In Benedict, SH; Schlesinger, DJ; Goetsch, SJ; Kavanagh, BD. Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy. Boca Raton: CRC Press. pp. 156–159.
  6. ↑ Khan, FR; Henderson, JM (2013). "Deep Brain Stimulation Surgical Techniques". In Lozano, AM; Hallet, M. Brain Stimulation: Handbook of Clinical Neurology 116. Amsterdam: Elsevier. pp. 28–30.
  7. ↑ Arle, J (2009). "Development of a Classic: the Todd-Wells Apparatus, the BRW, and the CRW Stereotactic Frames". In Lozano, AM; Gildenberg, PL; Tasker, RR. Textbook of Stereotactic and Functional Neurosurgery. Berlin: Springer-Verlag. pp. 456–461.
  8. ↑ Sharan, AD; Andrews, DW (2003). "Stereotactic Frames: Technical Considerations". In Schulder, M; Gandhi, CD. Handbook of Stereotactic and Functional Neurosurgery. New York: Marcel Dekker. pp. 16–17.
  9. ↑ Apuzzo, MLJ; Fredericks, CA (1988). "The Brown-Roberts-Wells System". In Lunsford, LD. Modern Stereotactic Neurosurgery. Boston: Martinus Nijhoff Publishing. pp. 63–77.
  10. ↑ Brown RA, Nelson JA (June 2012). "Invention of the N-localizer for stereotactic neurosurgery and its use in the Brown-Roberts-Wells stereotactic frame". Neurosurgery 70 (Operative Supplement 2): 173–176. doi:10.1227/NEU.0b013e318246a4f7. PMID 22186842.
  11. ↑ Thomas DG, Anderson RE, du Boulay GH (January 1984). "CT-guided stereotactic neurosurgery: experience in 24 cases with a new stereotactic system". Journal of Neurology, Neurosurgery & Psychiatry 47 (1): 9–16. doi:10.1136/jnnp.47.1.9. PMC: 1027634. PMID 6363629.
  12. ↑ Heilbrun MP, Sunderland PM, McDonald PR, Wells TH Jr, Cosman E, Ganz E (1987). "Brown-Roberts-Wells stereotactic frame modifications to accomplish magnetic resonance imaging guidance in three planes". Applied Neurophysiology 50 (1-6): 143–152. doi:10.1159/000100700. PMID 3329837.
  13. ↑ Leksell L, Leksell D, Schwebel J (January 1985). "Stereotaxis and nuclear magnetic resonance". Journal of Neurology, Neurosurgery & Psychiatry 48 (1): 14–18. doi:10.1136/jnnp.48.1.14. PMC: 1028176. PMID 3882889.
  14. ↑ Levivier M, Massager N, Wikler D, Lorenzoni J, Ruiz S, Devriendt D, David P, Desmedt F, Simon S, Van Houtte P, Brotchi J, Goldman S (July 2004). "Use of stereotactic PET images in dosimetry planning of radiosurgery for brain tumors: clinical experience and proposed classification". Journal of Nuclear Medicine 45 (7): 1146–1154. PMID 15235060.

See also

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