Division of Pediatric Neurosurgery, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
Adv Tech Stand Neurosurg. 2024;53:13-25. doi: 10.1007/978-3-031-67077-0_2.
The primary objective of surgery for brain tumor resection has always been maximizing safe resection while minimizing the risk to normal brain tissue. Technological advances applied in the operating room help surgeons to achieve this objective. This chapter discusses specific tools and approaches in the operating environment that target safe surgery for brain tumors in children, with a focus on pathologies in the sellar/suprasellar region. Particular focus is given to tools that help with safe patient positioning; intraoperative imaging modalities; and chemical visualization adjuncts. Both static (preoperative images used for neuronavigation) and dynamic (images updated during the procedure) intraoperative imaging modalities are discussed. There is further overview of operative rehearsal and preparation strategies, which are rapidly evolving as virtual reality systems become more commonplace. While the rapid evolution of intraoperative adjuncts in neurosurgery means the status of a given technology as novel is quite transient, this chapter offers a snapshot of the current state of advanced intraoperative tools for pediatric brain tumor surgery.
手术切除脑肿瘤的主要目标一直是在最大程度减少正常脑组织损伤的风险的前提下，实现安全切除肿瘤。术中应用的技术进步有助于外科医生实现这一目标。本章讨论了在手术环境中针对儿童脑肿瘤安全手术的具体工具和方法，重点介绍了鞍区/鞍上区域的病变。特别关注有助于安全患者定位的工具、术中成像方式和化学可视化辅助手段。讨论了静态（用于神经导航的术前图像）和动态（手术过程中更新的图像）术中成像方式。还进一步概述了手术预演和准备策略，随着虚拟现实系统变得越来越普遍，这些策略正在迅速发展。虽然神经外科术中辅助手段的快速发展意味着某种技术的新颖性状态相当短暂，但本章提供了小儿脑肿瘤手术中当前先进术中工具的现状快照。
