Endoscopic laser surgery for intraparenchymal brain lesions with computed stereotactic guiding system

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Abstract
Image-guided stereotactic endoscopy has made possible the accurate viewing of deep-seated brain lesions through a limited space. The use of endoscopy for the resection of pathological lesions, however, remains difficult because of the limited number of surgical instruments and techniques applicable. The authors recently developed an open-system endoscopy using a stereotactic guiding tube with an open window. Through this window, the surgeon can freely manipulate various microsurgical instruments and employ such techniques as laser vaporization. Using this approach, more than 25 intracerebral tumors were resected either totally or partially with complete hemostasis under direct visualization. Since this approach is an image-guided surgery, it is indispensable to plan and simulate the operation pre-surgically based on computerized brain images and also to monitor the real-time coordinates of the manipulating sites intra-operatively. In this report, a new advancement in the computed stereotactic guiding system for this endoscopic surgery is described.

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