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Stereotactic Surgery is a minimally invasive form of surgical intervention which makes use of a three-dimensional coordinate system to locate small targets inside the body and to perform an action such as ablation, biopsy, lesion, injection, stimulation, implantation, or radiosurgery (SRS). This technique allows for more precise localization of the pathology, thereby minimizing the damage to the surrounding tissue.

History

The concept of stereotactic surgery was first introduced in the early 20th century. The development of this technique is attributed to several researchers, including Horsley and Clarke, who in 1908 devised the first stereotactic apparatus for use in animal studies. The application of stereotactic methods to human patients began in the 1940s and 1950s, with the work of Spiegel and Wycis, who are credited with performing the first human stereotactic procedure.

Procedure

Stereotactic surgery involves the use of three-dimensional imaging techniques, such as Computed Tomography (CT) or Magnetic Resonance Imaging (MRI), to guide the operation. The patient's head is usually fixed in a frame to ensure precision during the procedure. The surgeon then uses the images to plan the entry point and the trajectory to reach the target area with minimal disruption to the surrounding tissues.

Applications

Stereotactic surgery is used in the treatment of various medical conditions, including:

• Brain tumors: For biopsy or removal of tumors with high precision.
• Parkinson's disease: For deep brain stimulation (DBS) to reduce symptoms.
• Epilepsy: For accurately identifying and treating seizure foci.
• Arteriovenous malformations (AVMs): For targeted radiation therapy or surgical removal.
• Psychiatric disorders: For experimental treatments such as deep brain stimulation for severe depression.

Advantages

The main advantages of stereotactic surgery include:

• Reduced risk of complications and infection due to its minimally invasive nature.
• Shorter recovery time compared to traditional open surgery.
• Increased precision and accuracy in targeting the pathological area, leading to better outcomes.

Risks

While stereotactic surgery is generally safe, it carries some risks, such as:

• Bleeding or hemorrhage at the target site.
• Infection, although rare due to the minimally invasive approach.
• Adverse reactions to anesthesia.
• Potential damage to surrounding brain tissue, leading to neurological deficits.

Future Directions

Advancements in imaging technology and robotic surgery are expected to further refine stereotactic surgical techniques, making them more accurate and less invasive. Research is also ongoing in the application of stereotactic methods to treat a wider range of conditions, including psychiatric disorders and chronic pain.