Ralf A Kockro1, Tim Killeen2, Ali Ayyad3, Martin Glaser3, Axel Stadie3, Robert Reisch4, Alf Giese3, Eike Schwandt3. 1. Department of Neurosurgery, Hirslanden Hospital, Zurich, Switzerland; Department of Neurosurgery, University Hospital Mainz, Mainz, Germany. Electronic address: ralf.kockro@hirslanden.ch. 2. Department of Neurosurgery, Hirslanden Hospital, Zurich, Switzerland. 3. Department of Neurosurgery, University Hospital Mainz, Mainz, Germany. 4. Department of Neurosurgery, Hirslanden Hospital, Zurich, Switzerland; Department of Neurosurgery, University Hospital Mainz, Mainz, Germany.
Abstract
OBJECTIVE: Aneurysm surgery demands precise spatial understanding of the vascular anatomy and its surroundings. We report on a decade of experience planning clipping procedures preoperatively in a virtual reality (VR) workstation and present outcomes with respect to mortality, morbidity, and aneurysm occlusion rate. METHODS: Between 2006 and 2015, the clipping of 115 intracranial aneurysms in 105 patients was preoperatively planned with the Dextroscope, a stereoscopic, patient-specific VR environment. The outcome data for all cases, planned and performed in 3 institutions, were analyzed based on clinical charts and radiologic reports. RESULTS: Eighty-five incidental, unruptured aneurysms in 77 patients were electively planned and treated surgically. Mortality was 0% and morbidity (modified Rankin Scale score >2) was 2.6%. The rate of complete aneurysm obliteration on postoperative imaging was 91.8%. In addition, 30 aneurysms were treated in 28 patients with previous subarachnoid hemorrhage. Mortality in these cases was 3.6%, morbidity (modified Rankin Scale score >2) 7.1%, and the rate of complete aneurysm clipping was 90%. CONCLUSIONS: Meticulous three-dimensional surgical planning in a VR environment enhances the surgeon's spatial understanding of the individual vascular anatomy and allows clip preselection and positioning as well as anticipation of potential difficulties and complications. VR planning was associated, in this multi-institutional series, with excellent clinical outcomes and rates of complete aneurysm closure equivalent to benchmark cohorts. Copyright Â
OBJECTIVE:Aneurysm surgery demands precise spatial understanding of the vascular anatomy and its surroundings. We report on a decade of experience planning clipping procedures preoperatively in a virtual reality (VR) workstation and present outcomes with respect to mortality, morbidity, and aneurysm occlusion rate. METHODS: Between 2006 and 2015, the clipping of 115 intracranial aneurysms in 105 patients was preoperatively planned with the Dextroscope, a stereoscopic, patient-specific VR environment. The outcome data for all cases, planned and performed in 3 institutions, were analyzed based on clinical charts and radiologic reports. RESULTS: Eighty-five incidental, unruptured aneurysms in 77 patients were electively planned and treated surgically. Mortality was 0% and morbidity (modified Rankin Scale score >2) was 2.6%. The rate of complete aneurysm obliteration on postoperative imaging was 91.8%. In addition, 30 aneurysms were treated in 28 patients with previous subarachnoid hemorrhage. Mortality in these cases was 3.6%, morbidity (modified Rankin Scale score >2) 7.1%, and the rate of complete aneurysm clipping was 90%. CONCLUSIONS: Meticulous three-dimensional surgical planning in a VR environment enhances the surgeon's spatial understanding of the individual vascular anatomy and allows clip preselection and positioning as well as anticipation of potential difficulties and complications. VR planning was associated, in this multi-institutional series, with excellent clinical outcomes and rates of complete aneurysm closure equivalent to benchmark cohorts. Copyright Â
Authors: Antonio Gangemi; Betty Chang; Paolo Bernante; Gilberto Poggioli Journal: Int J Environ Res Public Health Date: 2021-12-03 Impact factor: 3.390
Authors: Diana Anthony; Robert G Louis; Yevgenia Shekhtman; Thomas Steineke; Anthony Frempong-Boadu; Gary K Steinberg Journal: J Neurosurg Case Lessons Date: 2021-06-07
Authors: Georges Hattab; Adamantini Hatzipanayioti; Anna Klimova; Micha Pfeiffer; Peter Klausing; Michael Breucha; Felix von Bechtolsheim; Jens R Helmert; Jürgen Weitz; Sebastian Pannasch; Stefanie Speidel Journal: Sci Rep Date: 2021-06-29 Impact factor: 4.379