Background: Magnified intraoperative visualization is of paramount importance during microsurgical procedures. Although the introduction of the operating microscope represented one of the most relevant innovations in modern neurosurgery, surgical vision and maneuverability can be limited in cases with unfavorable angles of attack. In such cases, the placement of the operating microscope can be difficult and result in significant discomfort to the surgeon. In previous decades, exoscopes were introduced as alternative tools to provide optimal ergonomics by decoupling the line of sight of the surgeon from the binocular lenses. However, exoscopic platforms entail interim manual adjustments of the camera position and setting. To overcome this limitation, robotic-assisted digital microscopy was developed. We have reported our preliminary experience with the RoboticScope to investigate the feasibility and safety of this novel digital system for intraoperative magnification.
Methods: In September 2020, the RoboticScope was used to perform 3 cranial procedures for the resection of brain tumors. The surgeon's opinion was recorded to evaluate the quality of the intraoperative vision, the safety and efficacy of the surgical maneuverability, and the surgeon's personal comfort.
Results: RoboticScope provided remarkable advantages in terms of enhanced workflow efficacy and increased comfort of the surgeon during the microsurgical phase of the cranial procedures. The overall quality of the intraoperative digital imaging was rated not inferior to that of traditional optical microscopes.
Conclusions: The RoboticScope is a promising device that might represent a valuable alternative to conventional tools for intraoperative visualization in the resection of intracranial tumors.
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http://dx.doi.org/10.1016/j.wneu.2021.05.075 | DOI Listing |
World Neurosurg
January 2025
Neurosurgical Fellow, Stroke Team México, American Association of Neurological Surgeons Student Chapter, Universidad Autónoma del Estado de Hidalgo, Hidalgo, 42160, México.
Introduction: Meningiomas are the most common primary central nervous system tumors, often requiring surgical resection. Presurgical embolization (PSE) is used to reduce intraoperative bleeding, although its effectiveness varies. This study evaluates the safety and efficacy of PSE using ethyl-vinyl alcohol (EVOH) in meningioma surgeries.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Neurosurgery Department, Santa Maria delle Grazie Hospital, ASL Napoli 2 Nord, Via Domitiana Località La Schiana Pozzuoli, 80078 Naples, Italy.
Background: Although its validity has recently been questioned since its introduction, the Simpson grade has remained one of the most relevant factors in estimating the recurrence risk of intracranial meningiomas. This study aims to assess its role in spinal meningiomas through a retrospective analysis of a mono-institutional surgical series and literature meta-analysis.
Methods: We conducted a systematic review and meta-analysis of the literature from 1980 to 2023, complemented by a mono-institutional series of 74 patients treated at "Santa Maria delle Grazie" hospital.
Neuro Oncol
December 2024
Department of Neurological Surgery, Mayo Clinic; Rochester, MN, USA.
Background: While serial sampling of glioma tissue is rarely performed prior to recurrence, cerebrospinal fluid (CSF) is an underutilized longitudinal source of candidate glioma biomarkers for understanding therapeutic impacts. However, the impact of key variables to consider in longitudinal CSF samples for monitoring biomarker discovery, including anatomical location and post-surgical changes, remains unknown.
Methods: Aptamer-based proteomics was performed on 147 CSF samples from 74 patients, 71 of whom had grade 2-4 astrocytomas or grade 2-3 oligodendrogliomas.
Neuro Oncol
December 2024
Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA.
Cerebrospinal fluid (CSF) has emerged as a valuable liquid biopsy source for glioma biomarker discovery and validation. CSF produced within the ventricles circulates through the subarachnoid space, where the composition of glioma-derived analytes is influenced by the proximity and anatomical location of sampling relative to tumor, in addition to underlying tumor biology. The substantial gradients observed between lumbar and intracranial CSF compartments for tumor-derived analytes underscore the importance of sampling site selection.
View Article and Find Full Text PDFFluids Barriers CNS
January 2025
Department of Anatomy, Cellular and Molecular Neurobiology Research Group, Faculty of Medicine, Masaryk University, 625 00, Brno, Czech Republic.
Brain metastases (BMs) are the most common intracranial tumors in adults and occur 3-10 times more frequently than primary brain tumors. Despite intensive multimodal therapies, including resection, radiotherapy, and chemotherapy, BMs are associated with poor prognosis and remain challenging to treat. BMs predominantly originate from primary lung (20-56%), breast (5-20%), and melanoma (7-16%) tumors, although they can arise from other cancer types less frequently.
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