Al-Saiari Sultan, Farag Ahmed A, Al Orabi Khalid, Abdoh Mohammad, Kheshaifati Hussein
Neurological Surgery, King Abdullah Medical City, Mecca, SAU.
Cureus. 2020 Dec 9;12(12):e12002. doi: 10.7759/cureus.12002.
Published articles pertaining to possible ways to increase the accuracy of image-guided frameless surgery are abundant in the literature. Accurate target localization is dependent on many factors, of which noteworthy is the meticulous registration and constant fixation of instruments during the procedure. Frequent changing of instruments' application or inadvertent destabilization of its fixation during surgery after registration might disrupt the preset navigation measurements, leading to inaccurate targeting. Technical wise, we managed to avoid the drawback of moving the aiming device repeatedly during the procedure, as we will discuss later. This retrospective study aims to evaluate the feasibility and reliability of a simple frameless technique we used in navigation-guided brain biopsy and to show how it refines the accuracy of frameless biopsy procedures. All procedures were performed at our institution in the period from 2018 to 2019 and included 10 patients with different brain lesions. The mean operative time using our technique was noticeably short (18 minutes) and the standard deviation was 2.1. The used technique was easy, undemanding, and reliable in obtaining samples from brain tumors, guaranteeing more precision by applying an all-time fixed and stable navigation reference hardware.
文献中充斥着大量关于提高图像引导无框架手术准确性的可能方法的已发表文章。精确的靶点定位取决于许多因素，其中值得注意的是在手术过程中进行细致的配准和持续固定器械。在配准后手术过程中频繁更换器械的应用或意外使其固定不稳定，可能会扰乱预设的导航测量，导致靶点定位不准确。从技术角度讲，我们成功避免了在手术过程中反复移动瞄准装置的缺点，这一点我们将在后面讨论。这项回顾性研究旨在评估我们在导航引导脑活检中使用的一种简单无框架技术的可行性和可靠性，并展示它如何提高无框架活检程序的准确性。所有手术均于2018年至2019年在我们机构进行，包括10例患有不同脑病变的患者。使用我们的技术的平均手术时间明显较短（18分钟），标准差为2.1。所使用的技术简单、要求不高，并且在从脑肿瘤获取样本方面可靠，通过应用始终固定且稳定的导航参考硬件保证了更高的精度。
