Undoubtedly, this kind of surgical incision is more precise, and it uses a non-surgical conventional incision. It can be adjusted according to the patient's specific lesions, and precise positioning can be achieved according to individual differences.
The whole operation sounds wonderful and demonstrates the magic of modern medicine.
The family members were happy to hear this. Only the doctors themselves knew that it was impossible to achieve perfect precision surgery with existing medical technology. Some technical difficulties had not been completely overcome, and obstacles always existed.
If three-dimensional navigation can really be 100% accurate, even brainiacs like Cao Yong would envy the three-dimensional computing brain of the junior sister.
Specifically, the biggest problem with three-dimensional navigation is that it is not a real-time image, which is far inferior to the almost real-time angiography images of the interventional surgery introduced earlier.
If you want to do real-time imaging, first of all, the operating room needs to have powerful hardware. For example, the high-end hybrid operating room that will be built in the new building of the National Association of Surgery will be equipped with CT, which can provide patients with real-time CT images at any time. In addition, a CT scan is much more expensive than angiography. It is impossible to do CT scans frequently during surgery like angiography. Checking so many CT images at a time requires synthesis and reading, which also consumes surgical time.
In the absence of hardware support, all the hospital can do is to work harder before the operation.
The doctor preliminarily planned the surgical approach based on his medical experience, pasted positioning markers on the patient's scalp surface, and then asked the patient to undergo a second head CT scan.
The secondary CT scan image is input into the 3D navigation system, and scalp marker points will appear in the 3D image. The doctor uses the markers to make the patient's head in reality overlap with the 3D image head, forming a more accurate reference map in the doctor's impression.
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In order to pursue greater precision, doctors will put a head frame on the patient during adult surgery. There are various scales on the head frame to measure the patient's head shape parameters. This operation method belongs to framed three-dimensional calibration. Compared with the frameless three-dimensional calibration mentioned above, it is a relatively primitive scalp incision positioning method in neurosurgery.
Speaking of the current patients being children, children are not allowed to use head frames. Head frames are too heavy, and children's skulls are weaker than adults'. Doctors are afraid of accidents when using head frames, so they try to avoid it.
Even if all these preparations are done well, I'm sorry that there may still be problems with positioning during surgery. This is a common error in minimally invasive neurosurgery using a three-dimensional navigation system. The academic name is image drift. Statistical data show that the incidence of this error can reach more than 60%.
The reason is that there is cerebrospinal fluid flowing in the brain. As long as the patient's head moves, the cerebrospinal fluid will flow and cause changes in the brain tissue. During the operation, the patient's head is fixed and does not move, but the doctor needs to find something in the tofu-like brain and move the brain tissue, so the position and shape of the brain tissue will change again. The brain tissue is soft and easily passive.
Therefore, to achieve real-time precision in neurosurgery, it is necessary to have real-time imaging image input software to adjust the three-dimensional image. The above mentioned many reasons why real-time imaging input is not possible, so it is impossible to adjust the three-dimensional image in real time during surgery.
The only way to break through is artificial intelligence, which relies on computers to calculate and deduce the images of brain tissue movement in real time.
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