Advanced Intraoperative Technologies In Neurosurgery

Since the introduction of electrosurgery the techniques of surgery on the nervous system have passed through further improvements (bipolar coagulation, microscope), even if the procedure was not substantially modified. Today, laser represents a new "discipline", as it offers a new way of performing all basic maneuvers (dissection, demolition, hemostasis, vessel sutures). Furthermore, laser offers the possibility of a special maneuver, namely reduction of the volume of a tumoral mass through vaporization. Its application is not restricted to traditional neurosurgery but extends also to stereotactic and vascular neurosurgery. Laser surgery has also influenced the anesthesiologic techniques. At the same time new instrumentation has been introduced: CUSA ultrasonic aspiration, echotomography, and Doppler flowmeter. I have had the chance to utilize these new technologies all at a time and have come to the conclusion that we are facing the dawn of a new methodology which has already shown its validity and lack of inconveniences, and whose object is to increase the precision of neurological surgery. The technological development is still going on, and some improvements are to be foreseen. Laser scalpel is splitting the initial laser surgery into NO TOUCH and TOUCH surgery with laser. As new instrumentarium will be developed, a variable and tunable beam will become available. For example, in a few years Free Electron Laser will further add to the progress in this field.

Since the introduction of electrosurgery the techniques of surgery on the nervous system have passed through further improvements (bipolar coagulation, microscope), even if the procedure was not substantially modified. Today, laser represents a new "discipline", as it offers a new way of performing all basic maneuvers (dissection, demolition, hemostasis, vessel sutures). Furthermore, laser offers the possibility of a special maneuver, namely reduction of the volume of a tumoral mass through vaporization. Its application is not restricted to traditional neurosurgery but extends also to stereotactic and vascular neurosurgery. Laser surgery has also influenced the anesthesiologic techniques. At the same time new instrumentation has been introduced: CUSA ultrasonic aspiration, echotomography, and Doppler flowmeter. I have had the chance to utilize these new technologies all at a time and have come to the conclusion that we are facing the dawn of a new methodology which has already shown its validity and lack of inconveniences, and whose object is to increase the precision of neurological surgery. The technological development is still going on, and some improvements are to be foreseen. Laser scalpel is splitting the initial laser surgery into NO TOUCH and TOUCH surgery with laser. As new instrumentarium will be developed, a variable and tunable beam will become available. For example, in a few years Free Electron Laser will further add to the progress in this field.

Since the introduction of electrosurgery the techniques of surgery on the nervous system have passed through further improvements (bipolar coagulation, microscope), even if the procedure was not substantially modified. Today, laser represents a new "discipline", as it offers a new way of performing all basic maneuvers (dissection, demolition, hemostasis, vessel sutures). Furthermore, laser offers the possibility of a special maneuver, namely reduction of the volume of a tumoral mass through vaporization. Its application is not restricted to traditional neurosurgery but extends also to stereotactic and vascular neurosurgery. Laser surgery has also influenced the anesthesiologic techniques. At the same time new instrumentation has been introduced: CUSA ultrasonic aspiration, echotomography, and Doppler flowmeter. I have had the chance to utilize these new technologies all at a time and have come to the conclusion that we are facing the dawn of a new methodology which has already shown its validity and lack of inconveniences, and whose object is to increase the precision of neurological surgery. The technological development is still going on, and some improvements are to be foreseen. Laser scalpel is splitting the initial laser surgery into NO TOUCH and TOUCH surgery with laser. As new instrumentarium will be developed, a variable and tunable beam will become available. For example, in a few years Free Electron Laser will further add to the progress in this field.

An advanced technique quickly becoming the "standard" for all neurosurgeons! A comprehensive review of the state-of-the-art technology currently available for neuronavigation. It will provide the reader with the clinical applications of this technology to various aspects of cranial and spinal surgery.

Intraoperative imaging technologies have taken an ever-increasing role in the daily practice of neurosurgeons and the increasing attention and interest necessitated international interaction and collaboration. The Intraoperative Imaging Society was formed in 2007. This book brings together highlights from the second meeting of the Intraoperative Imaging Society, which took place in Istanbul-Turkey from June 14 to 17, 2009. Included within the contents of the book is an overview of the emergence and development of the intraoperative imaging technology as well as a glimpse on where the technology is heading. This is followed by in detail coverage of intraoperative MRI technology and sections on intraoperative CT and ultrasonography. There are also sections on multimodality integration, intraoperative robotics and other intraoperative technologies. We believe that this book will provide an up-to date and comprehensive general overview of the current intraoperative imaging technology as well as detailed discussions on individual techniques and clinical results.

From the Meeting on "Advanced Technology in Neurosurgery", held in Milan on May, 29 - June, 1, 1985

An excellent account of the developments which have occurred in neuro-navigation, with thought-provoking insights into the wider applications of equipment...-Journal of Neurology, Neurosurgery and Psychiatry Today neurological surgery stands at a technological crossroad. Revolutionary advances in high-speed graphic computers, informatics, biotechnology, and robotics continue to change the field and open vast new possibilities for improved patient care. In this new book, the advances at work in everyday patient care, as well as revolutionary new systems, now under development are chronicled by the world-renowned team of neurosurgeons, computer scientists, software engineers and others who have led the technological transformations. The book includes full information on transferring medical data into mapping strategies, viewing the clinical applications of stereotaxis, and observing fascinating new image-guided neurosurgical procedures in actual clinical practice. Most importantly, there is a full comparison of the different systems now in use so that the surgeon can make intelligent decisions about which to purchase. Special features include: Innovative computer models that show normal neuroanatomy and its pathologic alterations in exquisite three-dimensional detail The value of fusing state-of-the-art imaging modalities to localize targets for stereotactic neurosurgery, including functional mapping of speech and motor areas, tumor localization, etc. Advanced intraoperative imaging techniques, including modern adaptations of stereotactic frames and real-time imaging (e.g. ultrasound, intraoperative MRI and CT) The potential of robotic manipulation in cutting edge imaging environments The pros and cons of many of the advanced neurosurgical navigation systems now in use and how each fits your needs The results of the new technology? Enormous improvements in surgical planning, execution, safety, and overall patient management -- plus flexibility in developing successful combination strategies that incorporate surgery with advanced neurosurgical and radiosurgical techniques. Complete with 547 illustrations, including 170 in full-color, the book goes further than any current work in documenting the evolution of modern neurosurgical navigation. All neurosurgeons, especially those working in modern intracranial, spinal and peripheral nerve techniques, will find it invaluable, as will neuroradiologists, radiation oncologists, general surgeons, and biomedical engineers. For the next generation in image-guided neurosurgery, this state-of-the-art work contains information not found elsewhere.