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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(02): 258-263
DOI: 10.4103/ajns.AJNS_25_21
Original Article

Frameless free-hand navigation-guided biopsy for brain tumors: A simpler method with an endoscope holder

Takeshi Miyazaki
Department of Neurosurgery, Shimane University School of Medicine, Izumo
,
Mizuki Kambara
Department of Neurosurgery, Shimane University School of Medicine, Izumo
,
Yuta Fujiwara
Department of Neurosurgery, Shimane University School of Medicine, Izumo
,
Fumio Nakagawa
Department of Neurosurgery, Shimane University School of Medicine, Izumo
,
Tsutomu Yoshikane
Department of Neurosurgery, Shimane University School of Medicine, Izumo
,
Yasuhiko Akiyama
Department of Neurosurgery, Shimane University School of Medicine, Izumo
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Context/Aims: Given the limitations of current navigation-guided brain biopsy methods, we aimed to introduce a novel method and validate its safety and accuracy. Setting and Design: This was a retrospective study of twenty consecutive patients who underwent brain biopsy at Shimane University Hospital, Japan. Subjects and Methods: Clinical records of 13 and 7 patients who underwent brain biopsy with the novel frameless free-hand navigation-guided biopsy (FFNB) method or a framed computed tomography-guided stereotactic biopsy (CTGB) method, respectively, were retrospectively reviewed. We compared age, sex, tumor location, histological diagnosis, maximum size of the tumor (target), depth from target to cortical surface on the same slice of CT or magnetic resonance imaging, operative position, anesthesia method, setup time for biopsy, incision-to-closure time, trial times for puncture, success rate, and complications in the two groups. Statistical Analysis: Fisher's exact test and the Wilcoxon rank-sum test were performed. Results: Clinical characteristics and lesion size did not differ significantly between the FFNB and CTGB groups. The depth of the target lesion was significantly greater in the CTGB group (P < 0.05). All FFNB and CTGB procedures reached and obtained the target tissue. The number of punctures and the average incision-to-closure time did not differ between the FFNB and CTGB groups. However, the preoperative setup time was significantly shorter using FFNB (P = 0.0003). No complications were observed in either group. Conclusions: FFNB was comparable with CTGB in terms of safety, accuracy, and operative duration. The preoperative setup time was shorter using FFNB. Therefore, FFNB is a feasible method for brain tumor biopsy.

Key-words:

Biopsy - brain tumor - free hand - navigation

Financial support and sponsorship

Nil.




Publication History

Received: 19 January 2021

Accepted: 02 March 2021

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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