Taiwan’s Electro Magnetic Legend – Integrated Electromagnetic Navigation in Minimally Invasive Brain Surgery without Complications

Minimally Invasive Brain Surgery with Magnetic Navigation Offers Safer Option with Smaller Incision. The team has plans to continue to expand the world-class intelligent integrated neurosurgical suite, including using 3D images for endoscopic lumbar procedures, introducing innovative techniques such as minimally invasive computer-assisted techniques to spinal surgeries, and applying augmented reality to surgery, rehabilitation, and training to benefit more patients.
Brain surgery is becoming safer thanks to surgical navigation systems.  Surgical navigation systems fall into one of two categories: infrared optical navigation and electromagnetic (EM) navigation. Using a magnetic field generator, EM systems create a 50 cm cube of magnetic field to precisely establish locations in 3D and provide trajectory planning. EM systems avoid the occlusion errors as well as the issues typically associated with the head frame of the optical system: injury, pain, and even damage to infant skulls which have yet to complete growth. The neurosurgery division at Cheng Hsin General Hospital installed a world-class intelligent integrated surgical navigation platform over two years ago. The system reconstructs 3D images out of presurgical 2D scans of the patients using computers and marks the location of the lesion. Then, the computer navigation function helps the doctor plot a safer trajectory for the minimally invasive surgery andremove the lesion entirely with better precision. This greatly minimizes the damage to normal nerve tissues, and the safety and success rate of the surgery is significantly improved.

In the past 3 years, the team has completed more than 90 minimally invasive surgeries aided by magnetic navigation systems without complications. The head of the neurosurgery division, Dr. Wen-Shin Song, said that surgeries aided by magnetic navigation systems have an incision that is 50% smaller as well as a recovery period that is shorter by more than 50%. Some patients could leave the bed or even go home the day after the brain surgery. Attending doctor Meng-Ting Wu of the Neurosurgery Division mentioned the case of an 85-year-old grandma who suffered from trigeminal neuralgia to the extent where even the wind blowing by would cause her pain and she could barely eat. After Dr. Wu inserted an implantable cotton square between the vessel and nerve that were applying pressure on each other through a minimally invasive surgery aided by magnetic navigation, the grandma was finally freed from the pain that kept her from speaking and laughing properly for nearly 20 years.

The Neurosurgery Division at Cheng Hsin General Hospital has developed many innovative surgical methods that have reduced the fear and pain associated with surgery in patients with smaller incisions and better precision. As a result, the safety and qualify of surgeries are greatly improved. Several examples include:
Using magnetic navigation system to assist with ventriculoperitoneal shunt surgery
Using magnetic navigation system to assist with surgical removal of pituitary adenoma
Using the magnetic navigation system to guide an acute intracerebral hematoma aspiration and drainage procedure
Using the navigation system to assist with difficult surgeries on the posterior fossa tumor
Treating trigeminal neuralgia with radiofrequency thermocoagulation assisted by magnetic navigation

The team also plans to continue to expand the integrated navigation operating room. This includes using 3D images for endoscopic lumbar procedures and applying augmented reality to surgery, rehabilitation, and training. Since over 60% of the nearly 700 surgeries performed by the division are on the spine, the team will continue to introduce innovative techniques such as minimally invasive computer-assisted techniques to spinal surgeries to benefit more patients. However, more advanced instruments providing a spatially bigger magnetic field are required, which could hopefully be realized in the near future.

(Editing by Nicole Yang, Research Center for Biotechnology and Medicine Policy)