Computational image analysis of distortion, sharpness, and depth of field in a next-generation hybrid exoscopic and microsurgical operative platform.

Objective: The development of surgical microscope-associated cameras has given rise to a new operating style embodied by hybrid microsurgical and exoscopic operative systems. These platforms utilize specialized camera systems to visualize cranial neuroanatomy at various depths. Our study aims to understand how different camera settings in a novel hybrid exoscope system influence image quality in the context of neurosurgical procedures.

Interactive microsurgical anatomy education using photogrammetry 3D models and an augmented reality cube.

Objective: This study sought to assess the use of an augmented reality (AR) tool for neurosurgical anatomical education.

Methods: Three-dimensional models were created using advanced photogrammetry and registered onto a handheld AR foam cube imprinted with scannable quick response codes. A perspective analysis of the cube anatomical system was performed by loading a 3D photogrammetry model over a motorized turntable to analyze changes in the surgical window area according to the horizontal rotation.

Step-by-Step Dissection of the Extreme Lateral Transodontoid Approach to the Anterior Craniovertebral Junction: Surgical Anatomy and Technical Nuances.

Background: Multicompartmental lesions of the anterior craniovertebral junction require aggressive management. However, the lesions can be difficult to reach, and the surgical procedure is difficult to understand. The aim of this study was to create a procedural, stepwise microsurgical educational resource for junior trainees to learn the surgical anatomy of the extreme lateral transodontoid approach (ELTOA).

Infragalenic triangle as a gateway to dorsal midbrain and posteromedial thalamic lesions: descriptive and quantitative analysis of microsurgical anatomy.

Objective: Anatomical triangles provide neurosurgeons with the specificity required to access deep targets, supplementing more general instructions, such as craniotomy and approach. The infragalenic triangle (IGT), bordered by the basal vein of Rosenthal (BVR), precentral cerebellar vein (PCV), and the quadrangular lobule of the cerebellum, is one of a system of anatomical triangles recently introduced to guide dissection to brainstem cavernous malformations and has not been described in detail. This study aimed to quantitatively analyze the anatomical parameters of the IGT and present key nuances for its microsurgical use.

Modified Puerto Rico Recurrence Scale for chronic subdural hematomas: augmenting the grading scale with postoperative pneumocephalus volume.

Background: Chronic subdural hematomas (CSDHs) are common in the elderly, with a relatively high rate of recurrence after initial surgical intervention. Our research team previously created a predictive grading system, the Puerto Rico Recurrence Scale (PRRS), to identify patients at high risk of CSDH recurrence. In this study, we introduce a modification of the (mPRRS) that includes pneumocephalus volume, which has been independently associated with recurrence.

Quantification of motion during microvascular anastomosis simulation using machine learning hand detection.

Objective: Microanastomosis is one of the most technically demanding and important microsurgical skills for a neurosurgeon. A hand motion detector based on machine learning tracking technology was developed and implemented for performance assessment during microvascular anastomosis simulation.

Methods: A microanastomosis motion detector was developed using a machine learning model capable of tracking 21 hand landmarks without physical sensors attached to a surgeon's hands.

Three-Dimensional Modeling and Extended Reality Simulations of the Cross-Sectional Anatomy of the Cerebrum, Cerebellum, and Brainstem.

Background: Understanding the anatomy of the human cerebrum, cerebellum, and brainstem and their 3-dimensional (3D) relationships is critical for neurosurgery. Although 3D photogrammetric models of cadaver brains and 2-dimensional images of postmortem brain slices are available, neurosurgeons lack free access to 3D models of cross-sectional anatomy of the cerebrum, cerebellum, and brainstem that can be simulated in both augmented reality (AR) and virtual reality (VR).

Objective: To create 3D models and AR/VR simulations from 2-dimensional images of cross-sectionally dissected cadaveric specimens of the cerebrum, cerebellum, and brainstem.

Virtual neurosurgery anatomy laboratory: A collaborative and remote education experience in the metaverse.

Background: Advances in computer sciences, including novel 3-dimensional rendering techniques, have enabled the creation of cloud-based virtual reality (VR) interfaces, making real-time peer-to-peer interaction possible even from remote locations. This study addresses the potential use of this technology for microsurgery anatomy education.

Methods: Digital specimens were created using multiple photogrammetry techniques and imported into a virtual simulated neuroanatomy dissection laboratory.

Anatomic Depth Estimation and 3-Dimensional Reconstruction of Microsurgical Anatomy Using Monoscopic High-Definition Photogrammetry and Machine Learning.

Background: Immersive anatomic environments offer an alternative when anatomic laboratory access is limited, but current three-dimensional (3D) renderings are not able to simulate the anatomic detail and surgical perspectives needed for microsurgical education.

Objective: To perform a proof-of-concept study of a novel photogrammetry 3D reconstruction technique, converting high-definition (monoscopic) microsurgical images into a navigable, interactive, immersive anatomy simulation.

Methods: Images were acquired from cadaveric dissections and from an open-access comprehensive online microsurgical anatomic image database.

Development and Validation of a Novel Methodological Pipeline to Integrate Neuroimaging and Photogrammetry for Immersive 3D Cadaveric Neurosurgical Simulation.

Background: Visualizing and comprehending 3-dimensional (3D) neuroanatomy is challenging. Cadaver dissection is limited by low availability, high cost, and the need for specialized facilities. New technologies, including 3D rendering of neuroimaging, 3D pictures, and 3D videos, are filling this gap and facilitating learning, but they also have limitations.