Comput. Aided Surg. - Re-evaluation of the role of image guidance in minimally invasive pituitary surgery: benefits and outcomes.

Tópicos

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Resumo

JECTIVE: To evaluate the utility of performing endonasal transsphenoidal pituitary surgery with computer-based neuronavigation, and to examine the efficacy of computer-based neuronavigation compared to fluoroscopy.PATIENTS: We conducted a retrospective review of patients who underwent pituitary surgery between September 1998 and September 2008. Of 120 consecutive patients, 70 met inclusion criteria and were fully examined. The inclusion criteria were that patients had undergone endonasal transsphenoidal pituitary surgery performed by the same neurosurgeon at the same institution. Nineteen of the patients were treated using intraoperative fluoroscopy and 48 were treated using the BrainLAB VectorVision neuronavigation system. Preparation times, surgical times and associated complications were analyzed.RESULTS: Our results indicate that image guidance reduces the overall operating room time and complication rate. Average preparation time for fluoroscopy and computer-based neuronavigation was 70.3 and 67.3min, respectively (p=0.3299). Average surgical time with fluoroscopy and BrainLAB was 131 and 107.9min, respectively (p=0.0079). The results were also analyzed with regard to other parameters such as associated complications, age and diagnoses.CONCLUSION: Computer guided endoscopic endonasal transsphenoidal surgery provides a three-dimensional image to the surgeon, allowing for greater visual accuracy and surgical precision and a faster procedure without radiation exposure or the need for additional personnel.

Resumo Limpo

jectiv evalu util perform endonas transsphenoid pituitari surgeri computerbas neuronavig examin efficaci computerbas neuronavig compar fluoroscopypati conduct retrospect review patient underw pituitari surgeri septemb septemb consecut patient met inclus criteria fulli examin inclus criteria patient undergon endonas transsphenoid pituitari surgeri perform neurosurgeon institut nineteen patient treat use intraop fluoroscopi treat use brainlab vectorvis neuronavig system prepar time surgic time associ complic analyzedresult result indic imag guidanc reduc overal oper room time complic rate averag prepar time fluoroscopi computerbas neuronavig min respect p averag surgic time fluoroscopi brainlab min respect p result also analyz regard paramet associ complic age diagnosesconclus comput guid endoscop endonas transsphenoid surgeri provid threedimension imag surgeon allow greater visual accuraci surgic precis faster procedur without radiat exposur need addit personnel

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