Author: DR. N K VENKATARAMANA, Senior Consultant

Neurosurgery has evolved into the finest and sophisticated surgical branch due to technology adoption. Precision and safety have become the key factors of neurosurgery that enhanced the outcomes in recent years. Advances in imaging had shown the detailing of brain architecture like never before. Operating Microscope made every invisible part visible. However, wading through this complex structure is a real challenge. Neuronavigation made it all possible today.

Navigation technology is computer-assisted real-time guidance to the surgeon all through neurosurgery. While it orients the neurosurgeon to different locations and directions as we go through the brain, it also provides localization, orientation to the predetermined important areas and also helps to assess the progress of surgery in real-time. One can map the important areas, margins, and dimensions of the surgery, surgical access, and trajectories beforehand and follow-through while operating. One can make the opening very precise, making the whole surgery minimally invasive. This neuronavigation technique is beneficial in dealing with small lesions as well as deep-seated lessons in the brain. We can reach such targets precisely. In addition, placement of catheters, implants, drug delivery pumps, and biopsies can be performed very accurately.

The details of the MRI scan are fed into the computer in the operating room. The specialized software provides precise calculations, including the depth facilitating proper planning of neurosurgery using the shortest and the safest path. The computers and the instruments communicate with each other through infrared tracking. Simultaneously the relevant images and the locations will be displayed on the screen. Such technology was initially introduced in the war for precision bombing, localizing the targets precisely, and avoiding injury to civilian areas. Targets and places can be located precisely using the latitude and longitude measurements. The brain is also a three-dimensional space located in the skull. By taking the skull’s rigid landmarks, we can calculate measurements for any point in the brain. Using these calculations, we can reach them too accurately. This has provided access to many deep-seated locations in the brain and helpful for many new surgeries such as Deep brain stimulation for Parkinson’s disease, pain, epilepsy, and implantation of devices. Thus neuronavigation has contributed to the speed, safety, precision, and minimal tissue damage in neurosurgery.

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