Computer-assisted stereotactic microsurgery for the treatment of intracranial neoplasms.

This paper describes a stereotactic CO2 laser system for the removal of intra-axial, intracranial neoplasms. The volume of the neoplasm is transferred into stereotactic space by computer reconstruction of data derived by computed tomography (CT) performed under stereotactic conditions. The tumor volume is sliced in a plane orthogonal to the surgical approach, and slices at specific distances from the focal point of the stereotactic frame are displayed on a graphics monitor in the operating suite along with a cursor representing the position of the surgical laser. Laser vaporization of sequential slices of the tumor results in a cavity, the formation of which is monitored by anteroposterior and lateral roentgenograms. Fifteen stereotactic laser procedures have been performed on 13 patients, and the results are discussed. By this method, it is theoretically possible to remove all of an intracranial neoplasm detected by CT scanning.