Electromagnetic navigation-guided surgery in the semi-sitting position for posterior fossa tumours: a safety and feasibility study

Abstract

EM-guided neuronavigation in the semi-sitting position was safe and technically feasible. It enabled fast and accurate referencing without loss of navigation accuracy despite repositioning of the patient. In contrast to conventional opto-electric neuronavigation there were no line of sight problems.

The accuracy of an electromagnetic navigation system in lateral skull base approaches

“…Thus, the tip of the navigation stylus can be used when metallic devices are temporarily kept away. Hermann et al reported that they used the AxiEM neuronavigation system Medtronic Powered Surgical Solutions, Fort Worth, TX with the electromagnetic navigation, and there was no need to remove the retractor in sites deeper than the craniotomy margin . The susceptibility of this system to the inaccuracies caused by metallic instruments should be subjected to further examination.…”

“…Hermann et al reported that they used the AxiEM neuronavigation system Medtronic Powered Surgical Solutions, Fort Worth, TX with the electromagnetic navigation, and there was no need to remove the retractor in sites deeper than the craniotomy margin. 23 The susceptibility of this system to the inaccuracies caused by metallic instruments should be subjected to further examination. In this study, we used invasive fiducial markers on the temporal bone, forehead, and contralateral mastoid tip.…”

Shunt Surgery in Idiopathic Intracranial Hypertension Aided by Electromagnetic Navigation

“…It obviates the need for sharp head fixation offering a good alternative to optoelectric techniques, there are no line-of-sight problems, the position of the patient can be changed during surgery, and it allows the use of flexible instruments [24,31,33]. While it was shown to be beneficial especially in the placement of ventricular catheters for different indications [23,24,31,33,43,44], its advantages have been demonstrated also for many other neurosurgical procedures [22,25,26,27,34,45,46,47]. Studies on the accuracy of EM navigation have shown that it is comparable to optoelectric navigation ranging between 0.71-3.51 mm [48] and 0.7-4.4 mm [49].…”

“…The transmitter coil was fixed to the table at the side where the DRF was attached. Thereafter, registration of data sets for navigation and confirmation of accuracy were performed [26,27,33,34]. The planned entry point was marked on the patient's skin.…”

“…Both frame-based and frameless stereotactic techniques have been shown to be useful in the treatment of IIH [17,18,19] including robotic technology [20,21]. Electromagnetic (EM) navigation which can be performed without rigid head fixation has been used for various indications in neurosurgery [22,23,24,25,26,27,28]. Despite its multiple advantages, however, there is relatively little published experience with this technique in IIH [29,30,31,32], although it might be used much more frequently in daily routine.…”