10032-ST-3 Development of Surgical Support Tools for Magnetic Navigation System in Brain Tumor Surgery

Abstract Intraoperative real-time navigation is useful for safe and minimally invasive brain tumor surgery and has become widespread recently. The optical type or the magnetic type used as a tracking system for detecting location information have their own advantages and disadvantages, hopefully eliminating the disadvantages of each. We have developed a non-magnetic skin retractor and brain spatula to solve signal detection errors in magnetic navigation that are induced by magnetic materials present around the surgical field. A skin retractor, SJ retractor, was developed for use in burr hole surgery. The material is made of resin, the shape is ring-shaped. The SJ retractor is inserted into a skin incision to open wound. The non-magnetic brain spatula SP spatula was developed for use in craniotome surgery. The material is made of titanium, and the shape is based on the Vansant type brain spatula. The SP spatula is used to pull or squeeze brain tissue manually or in combination with a fixator. SJ retractor was used in 3 cases and SP spatula in 8 cases each. A representative case is presented for each. Case 1: A 80s year-old man was received an endoscopic biopsy for a brain tumor located at right corona radiata. After opening the wound with the SJ retractor, the Neuroport was inserted under the use of magnetic navigation. Case 2: A 60s year-old man was received an tumor resection by craniotome surgery for left temporal lobe tumor. The tumor was removed with manual use of the SP spatula under the support of magnetic navigation. There was no signal detection error in the navigation in both cases. Both the newly developed SJ retractor and SP spatula can be used without signal detection errors under magnetic navigation. Those may be highly useful as real-time surgical support devices.