The exoscope--a frame-based video/graphics system for intraoperative guidance of surgical resection.

A system has been devised to focus a video camera mounted on a CRW stereotactic frame onto the surgical field and to integrate the video picture with a computer-generated three-dimensional view of structures or targets deep within the brain. The surgical resection can then be done with the surgeon looking either at the composite picture on the video/computer monitor (as in almost all endoscopic surgery) or at the surgical field, to perform the resection using the conventional techniques most comfortable to the surgeon and most effective for the resection. The graphics platform on which the Exoscope program is built is the same as used for the RSA X-Knife stereotactic radiosurgery system. The X-Knife graphics program allows the reconstruction of a target mass (such as intracranial tumor) and desired objects (such as surrounding vessels) with accurate registration to stereotactic coordinates derived from the CRW localizing system. By mounting a video system through an externally mounted endoscope on the CRW arc, it is possible to orient the video image with great accuracy to this same stereotactic space. The two images are superimposed on a computer/video console in the operating room. The surgeon visualizes a real-time video image of the operating field upon which is a graphical representation of the computer-generated image of the target mass beneath the surface. In the corners are triplane orthogonal views through the center of target and a view parallel to the trajectory, so the surgeon may gauge his or her progress toward the target.(ABSTRACT TRUNCATED AT 250 WORDS)