Original Article   

Journal of Neurosurgical Sciences 2022 Apr 05

DOI: 10.23736/S0390-5616.22.05516-3

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

The “STARS” study: advanced pre-operative rehearsal and intraoperative navigation in neurosurgical oncology

Alessandro PERIN ^{1, 2, 3} ✉, Enrico GAMBATESA ^{1, 2}, Chiara B. RUI ^{1, 2}, Giovanni CARONE ^{1, 2}, Claudia FANIZZI ^{1, 2}, Francesca M. LOMBARDO ¹, Tommaso F. GALBIATI ^{1, 2}, Donatella SGUBIN ⁴, Paolo CAPPABIANCA ⁵, Torstein R. MELING ^{2, 6, 7}, Francesco DIMECO ^{1, 2, 6, 8, 9} The STARS Simulation Group

¹ Department of Neurosurgery, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Milano, Italy; ² Besta NeuroSim Center, Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta, Milano, Italy; ³ Department of Life Sciences, University of Trieste, Trieste, Italy; ⁴ Neurosurgery Department, Ospedale SS. Antonio e Biagio e C. Arrigo, Alessandria, Italy; ⁵ Department of Neurosurgery, Università Federico II, Napoli, Italy; ⁶ EANS Training Committee; ⁷ Neurosurgery Department, Hopitaux Universitaires de Genève, Geneva, Switzerland; ⁸ Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; ⁹ Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, MD, USA

BACKGROUND: Neurosurgical 3D visualizers and simulators are innovative devices capable of defining a surgical strategy in advance and possibly making neurosurgery safer by rehearsing the phases of the operation beforehand. The aim of this study is to evaluate Surgical Theater™, a new 3D neurosurgical planning, simulation, and navigation system, and qualitatively assess its use in the operating room.
METHODS: Clinical data were collected from 30 patients harbouring various types of brain tumours; Surgical Theater™ was used for the preoperative planning and intraoperative 3D navigation. Preoperative and postoperative questionnaires were completed by first and second operators to get qualitative feedback on the system’s functionality. Furthermore, we measured and compared the impact of this technology on surgery duration.
RESULTS: Neurosurgeons were overall satisfied when using this rehearsal and navigation tool and found it efficient and easy to use; interestingly, residents considered this device more useful as compared to their more senior colleagues (with significantly higher scores, p <0.05), possibly because of their limited anatomical experience and spatial/surgical rehearsal ability. The length of the surgical procedure was not affected by this technology (p >0.05).
CONCLUSIONS: Surgical Theater™ system was found to be clinically useful in improving anatomical understanding, surgical planning and intraoperative navigation, especially for younger and less experienced neurosurgeons.

KEY WORDS: Training; Simulation; Preoperative planning; Intraoperative 3D navigation; Surgical Theater