In the last 25 years, neurosurgery has been subject to a profound evolution. The impact of advanced technologies has completely changed the aspect of this medical discipline. During the seventies, the introduction of micro-surgical techniques gave way to the adoption of standards based on the practice of neurosurgery. In the successive years, this ruling philosophy has led to a radical development of miniaturization in surgical approaches. By the end of the nineties, we are witnessing the consolidation of minimal invasive neurosurgery. Dr. Enric Ferrer Rodriguez, head of neurosurgery in the University Hospital of Barcelona, has summarised the issue very clear in the Catalonian supercomputer magazine Teraflop: more surgical efficiency with less risks and less trauma for the patient.
In the past five years, the rapid development of communications and information technology has allowed high performance computing to enter various applications domains which remained inaccessible up till now because of the high cost. At this moment, we observe the diffusion and the use of neuro-imaging processing techniques. Neuro-images based on both computed tomography (CT) and magnetic resonance (MR) are being applied for diagnostic purposes and pre-operative planning by the neurosurgeon in order to determine the best strategy for medical intervention. The digital image processing techniques allow to generate spectacular motion captured 3D images.
This virtual reality approach enables the neurosurgeon to gain an improved knowledge of the medical problem through reconstruction and simulation of the affected region in the human body. As a result, the doctor will cultivate a higher degree of sensitivity when establishing a surgical strategy. Medical students equally benefit from virtual reality techniques. Surgical simulation indeed facilitates the correct training of medical procedures. In this way, the more carefully the surgical strategy has been prepared, the less risk there exists for unpleasant surprises to show up during medical intervention. The 3D motion captured reconstruction of cerebral structures in real time as well as the full immersion into a virtual environment offer the trainee the ability to perform surgery as if in reality.
"Augmented Reality" constitutes another innovative technique for the neurosurgeon to observe superimposed virtual structures by means of shutter glasses, which otherwise would have remained hidden under the surface. The design of surgical simulators requires a great deal of effort and precision. Nevertheless, there currently exist simulators for brain endoscopy which produce satisfying results for neurological training purposes. Here, we find ourselves at a point of no return. The implementation of high technology in the field of neurosurgery will require enormous investments as well as the formation of interdisciplinary teams from the medical facilities. Should we proceed with this evolution? According to Dr. Ferrer Rodriguez, there only can be one answer: yes, by all means.