Brainlab neuronavigation technology

NEUROSURGEONS in the country recently had a feel of advanced Brainlab neuronavigation system in brain surgeries. And, in the end, they reached a consensus that the technology is a must-have in all surgery departments across the country.

About 12 neurosurgeons, one-third of their population in Nigeria, said the digital technology made brain surgery a lot precise and faster, as they operated on seven patients, guided by the kolibri neuronavigation device, made by Brainlab.

One of the surgeries had tumour removed from a patient’s brain. The same operation was initially scheduled for mid-year by an Indian hospital.

The technology, being the first ever in West Africa, was brought on loan to Nigeria for the purpose of the just concluded one-week workshop hosted by the Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos.

Hitherto, decisions about approach planning for brain surgeries were based on static patient scan. Using the technology at the LUTH, however, digital patient data were uploaded to the kolibri neuronavigation system in the Operating Room (OR), helping the surgeons identify the right approach before making minimal incision.

Sylvain Delayat, who led a team of German experts to the workshop, said that since neuro-navigation tracks tools in real time and displays their position in relation to the patient’s data, the surgeons are guided through procedures, helping to keep skull openings small and minimize damage to healthy structures.

He said: “Regardless of the type of patient positioning, Brainlab neuronavigation offers four techniques for referencing patients to the system. Z-touch and Softtouch are based on surface matching, making patient registration quick and easy by simply touching the patients’ skin with either a pointer or a laser.”

“With the universal instrument holder VarioGuide, pre-planned trajectories can be targeted systematically within seconds and at any time during the neuronavigation procedure. Taking a biopsy, placing a shunt or guiding an endoscope, continuous position feedback and precise step-by-step workflow guidance is readily available without the need for a stereotactic frame. Proven passive-marker technology enables high accuracies and provides increased confidence,” he said.

He added that though the device was not a substitute for the surgeon, it rather makes their surgery faster, with easier focus on the task, smaller incision, scar and lesser stay in the Intensive Care Unit coupled with lesser risk of infection. “This device is helping to find the right way in the fast way.”

Consultant Neurosurgeon and Head of Neurosurgery Department, LUTH, Dr. Femi Bankole said it is like a map, accessible at every point and time of a journey.

“It is very useful for a neurosurgeon to have especially for lesions that are deep-seated inside the brain or in the spine. It is the first time that any system like this is being used in the country.

“Previously, what we have is the image of the patient. Then we would use our knowledge of anatomy and a lot of brainwork to decide where we think is the best. This device helps to decide the best without first having to open up the patient. It would be one of those things we want to have around to help us to improve our practice here in the country.”

He said they had really learned using the device that “makes surgery in the brain safer, faster, precise and accurate, even as the patient can go home with less morbidity and better treatment.”

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