Orienting oneself within the brain has been a major challenge since the 20th century, driving research to develop innovative technologies for precisely locating intracranial targets while minimizing surgical trauma. This thesis explores the evolution of these technologies, from stereotactic frame-based approaches to advanced augmented reality-guided systems, emphasizing their contributions to improving patient outcomes and surgical efficiency.
The first stereotactic frame-based systems utilized rigid specific frames to provide three-dimensional localization based on plain radiographs. However, their limited adaptability influenced the development of frameless systems. These frameless solutions integrate computer-assisted technologies and patient-based imaging to enable real-time instrument tracking and visualization. Despite significant progress, standard systems often lack flexibility during surgery, as they rely on preoperative imaging and 2D displays, requiring surgeons to mentally correlate data with the surgical field.
Augmented reality-guided neuronavigation represents a major advancement. By projecting 3D virtual objects through the surgical microscope or using specific goggles, surgeons gain enhanced spatial awareness and precision, while keeping their focus onto the surgical field. This thesis presents the superiority of augmented reality in accuracy and minimal invasiveness through experimental setups. Key innovations include intraoperative real-time recalibration using anatomical landmarks and interactive virtual roadmaps for sparing critical structures.
Furthermore, augmented reality systems are being adapted for education and minimally invasive procedures, including neuroendoscopy and robotic-assisted surgeries. Mixed reality tools have shown significant promise in medical training, fostering better understanding of complex neuroanatomy. However, the integration of real-time modalities, such as fluorescence-guided navigation, is essential to address limitations associated with static preoperative datasets.
In conclusion, this manuscript discusses the transformative potential of advanced neuronavigation, paving the way for safer, more precise, and minimally invasive neurosurgical practices, while emphasizing the critical role of continuous innovation and multidisciplinary collaboration.
