Free-standing, stereotactic, microsurgical retraction technique in "key hole" intracranial procedures

Free-standing, stereotactic, microsurgical retraction technique involves integration of a standard image-guided stereotaxis, an operating microscope and free-standing micro-retractors, data acquisition from computed tomography (CT) images, trajectory determination, and obtaining tumor configuration "in line" with the trajectory using standard CT computer program. The free-standing stereotactic micro-retractors are directed to the lesion using the stereotactic frame. The remainder of the procedure is carried out independent of the stereotactic frame. The technique allows unobstructed access to deep lesions through a "key-hole" opening with excellent visualization of the lesions, and accurate retractor placement. Independent retractor movement also allows visualization of the different corners of the wound. Experience with the first 15 consecutive procedures for stereotactic excision of deep lesions using the Patil frame is reported. Based on this preliminary experience, this technique is free of obstruction, accurate and safe.