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Stereotactic surgery is a form of minimally invasive Neurosurgery. In this surgery, Stereotactic equipment is used to accurately locate an area of interest within the brain; this can be a brain tumor or a group of nucleus depending on the indication of the surgery. The accuracy of this localisation is approximately 1-2 mm. Most of the stereotactic surgical procedures are done with the patient remaining fully awake through out the procedure. The typical stereotactic procedure involves fixation of a stereotactic frame (Fig. 1), |
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 Fig. 1. Fixation of stereotactic frame |
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which is done by infiltrating local anaesthetic at the site of pin fixation. Thereafter the patient undergoes a CT scan or MRI scan to locate the brain target and define its relationship to the frame. A computer, based on the data from CT, calculates the target coordinates and MRI scans. These target coordinates are than transferred onto the stereotactic arc apparatus (Fig. 2) |
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 Fig. 2. Stereotactic arc system used for target localisation |
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| and the target is approached either for biopsy, excision or for functional neurosurgery (Fig. 3). | |
 Fig. 3. Biopsy of a brain tumor in progress |
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Stereotactic surgery is essential for all functional neurosurgical procedures. It is useful for biopsies of deep seated lesions like thalamic tumors, brainstem tumors, third ventricular tumors or small tumors of less than few centimeters located anywhere in the brain. It is also useful to perform small-localized craniotomies for excising superficially located tumors, especially those that are located in and around vital centers like motor, sensory and speech areas. Stereotactic techniques are also used for emergency operations of brain haemorrhage, especially when the haematoma is deep seated. As majority of these operations are done with accurate localisation and without general anaesthesia (Fig. 4), |
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 Fig. 4. Surgical set up showing awake craniotomy |
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| the morbidity and mortality are minimal. The hospital stay and convalescence time is also significantly shortened. |
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