Stereotactic neurosurgery is a technique in which a rigid frame is applied to the patient's head and pre-operative images acquired. Because the frame and the lesion are visible in the images, the lesion can be located relative to the frame. Devices may then be attached to the frame to direct surgical instruments to the lesion. Conventional stereotactic neurosurgery remains a point by point process, conceptually little changed from the original devices which were designed for use with pneumoencephalograms. The exponential rise in the amount of available imaging information over the past 15 years has not been matched by intrasurgical applications. A new device will be presented which allows the intrasurgical position and trajectory to be displayed on preoperative images. This device has sub-millimetric accuracy and precision and is limited only by the image voxel size. The device can use both CT and MRI image sets concurrently or exclusively. Applications include surgical planning, biopsy, bone flap location and intracranial localization. Both phantom and clinical procedures will be shown.
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