Virtual reality system for planning minimally invasive neurosurgery. Technical note.
OBJECTIVE
The authors report on their experience with a 3D virtual reality system for planning minimally invasive neurosurgical procedures.


METHODS
Between October 2002 and April 2006, the authors used the Dextroscope (Volume Interactions, Ltd.) to plan neurosurgical procedures in 106 patients, including 100 with intracranial and 6 with spinal lesions. The planning was performed 1 to 3 days preoperatively, and in 12 cases, 3D prints of the planning procedure were taken into the operating room. A questionnaire was completed by the neurosurgeon after the planning procedure.


RESULTS
After a short period of acclimatization, the system proved easy to operate and is currently used routinely for preoperative planning of difficult cases at the authors' institution. It was felt that working with a virtual reality multimodal model of the patient significantly improved surgical planning. The pathoanatomy in individual patients could easily be understood in great detail, enabling the authors to determine the surgical trajectory precisely and in the most minimally invasive way.


CONCLUSIONS
The authors found the preoperative 3D model to be in high concordance with intraoperative conditions; the resulting intraoperative "déjà-vu" feeling enhanced surgical confidence. In all procedures planned with the Dextroscope, the chosen surgical strategy proved to be the correct choice. Three-dimensional virtual reality models of a patient allow quick and easy understanding of complex intracranial lesions.
Stadie
Axel Thomas
AT
Neuosurgery Clinic, Johannes Gutenberg University, Mainz, Germany. stadie@nc.klinik.uni-mainz.de
Kockro
Ralf Alfons
RA
Reisch
Robert
R
Tropine
Andrei
A
Boor
Stephan
S
Stoeter
Peter
P
Perneczky
Axel
A
D000236:Adenoma / Q000601:surgery; D000328:Adult; D000368:Aged; D000792:Angiography / Q000379:methods; D001932:Brain Neoplasms / Q000601:surgery; D003198:Computer Simulation; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D002532:Intracranial Aneurysm / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000601:surgery; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019635:Neurosurgical Procedures / Q000379:methods*; D010347:Patient Care Planning; D025321:Surgery, Computer-Assisted / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014584:User-Computer Interface