Onscreen-guided resection of extra-axial and intra-axial forebrain masses through registration of a variable-suction tissue resection device with a neuronavigation system

Vet Surg. 2020 May;49(4):676-684. doi: 10.1111/vsu.13414. Epub 2020 Mar 27.

Abstract

Objectives: To describe a novel surgical technique in which neuronavigation is used to guide a tissue resection device during excision of forebrain masses in locations difficult to visualize optically.

Study design: Short case series.

Animals: Six dogs and one cat with forebrain masses (five neoplastic, two nonneoplastic) undergoing excision with a novel tissue resection device and veterinary neuronavigation system.

Methods: The animals and resection instrument were coregistered to the neuronavigation system. Surgery was guided by real-time onscreen visualization of the resection instrument position relative to the preoperative MR images. Surgical outcome was evaluated by calculating residual tumor volume according to postoperative MRI.

Results: The technique was technically simple and led to the collection of diagnostic tissue samples in all cases. Postoperative MRI was available in six cases, two with gross-total resection, three with near-total resection, and one with subtotal resection.

Conclusion: Neuronavigation-guided resection of intra-axial and extra-axial brain masses with the resection device resulted in gross-total or near-total resection in five of six animals with tumors otherwise difficult to visualize. Risk of brain shift limited absolute reliance on navigation images.

Clinical significance: Real-time neuronavigation assistance is a feasible method for guidance and successful resection of brain masses that are poorly visualized because of intra-axial or deep location, tumor appearance, or hemorrhage.

MeSH terms

  • Animals
  • Brain Diseases / surgery
  • Brain Diseases / veterinary*
  • Brain Neoplasms / surgery
  • Brain Neoplasms / veterinary
  • Cats
  • Dogs
  • Female
  • Male
  • Neuronavigation / veterinary*
  • Prosencephalon / surgery*
  • Suction / veterinary