Stereotactic surgery or stereotaxy
In theory, any organ system inside the body can be subjected to stereotactic surgery. However, difficulties in setting up a reliable frame of reference (such as bone landmarks which bear a constant spatial relation to soft tissues) mean that its applications have been, traditionally and until recently, limited to brain surgery. Besides the brain, biopsy and surgery of the breast are done routinely to locate, sample (biopsy) and remove tissue. Plain X-ray images (radiographic mammography), computed tomography, and magnetic resonance imaging can be used to guide the procedure.
Stereotactic brain surgery is performed with a computer system that integrates previous imaging, usually a special MRI or CT performed one or two days before the surgery. This image is imported into the computer system that provides us with a 3-dimensional image of your brain and our intended target while we are in the operating room. We use this image, along with instruments that show us exactly where we are in the brain as we work to guide our removal of the target lesion.
Stereotactic brain surgery gives us the added advantage of planning as an small incision as possible over the target area of interest. This generally results in smaller incision, which results in better wound healing and smaller scars.
The biggest risk is bleeding in the tumor and brain from the surgery. Bleeding can cause anything from a mild headache up to a stroke, coma, or even death. The risk of bleeding following surgery is around 5% and the risk of mortality is around 1%. Additional risks can include headache from the surgical site, infection, and seizures. Additional risks can be posed by the anesthesia itself. To minimize risk, we ensure that a patient’s medical condition is optimized before beginning surgery, use of intraoperative antibiotics, stop all blood thinners including aspirin before surgery, and keep everyone overnight in the hospital for observation at the completion of surgery.
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