In Reply: Navigation-Linked Heads-Up Display in Intracranial Surgery: Early Experience

In Reply: Navigation-Linked Heads-Up Display in Intracranial Surgery: Early Experience CORRESPONDENCE Disclosure In Reply: Navigation-Linked Heads-Up Display The authors have no personal, financial, or institutional interest in any of the in Intracranial Surgery: Early Experience drugs, materials, or devices described in this article. To the Editor: We thank Meola and Chang for their thoughtful and well- informed review of our manuscript “Navigation-Linked Heads- Justin R. Mascitelli, MD Up Display in Intracranial Surgery: Early Experience.” We Joshua B. Bederson, MD are in agreement that our study plus others in the literature Department of Neurosurgery demonstrate feasibility of use but not necessarily effectiveness Barrow Neurological Institute as judged by operative room efficiency and patient outcomes. Phoenix, Arizona In our experience, the major limitations are (1) a cumbersome Department of Neurosurgery setup for typically nonmicroscopic portions of the procedure (skin Mount Sinai Health System incision, soft tissue dissection, craniotomy, and dural opening); New York, New York (2) the distractibility of objects injected into the microscope and associated learning curve; and (3) loss of accuracy for REFERENCES deep lesions. Despite these limitations, the heads-up display, or 1. Meola A, Chang SD. Letter: Navigation-linked heads-up display in Intracranial augmented reality, can be immensely helpful in certain situations, surgery: early experience. Oper Neurosurg. 2018;14(6):E71–E72. for example in optimizing the approach and in determining the 2. Mascitelli JR, Schlachter L, Chartrain AG, et al. Navigation-linked heads- location of critical structures in real time before they are encoun- up display in intracranial surgery: early experience. Oper Neurosurg. 2017. published ahead of print October 10, 2017 (doi: 10.1093/ons/opx205). tered. Currently the technology is young and rapidly evolving. Future steps include evaluating its efficacy compared to standard cases, practically implementing the technology throughout an entire surgery, reducing distractibility, and developing methods to maintain accuracy and most importantly restoring accuracy 10.1093/ons/opy049 throughout the case. OPERATIVE NEUROSURGERY VOLUME 14 | NUMBER 6 | JUNE 2018 | E73 Downloaded from https://academic.oup.com/ons/article-abstract/14/6/E73/4953682 by Ed 'DeepDyve' Gillespie user on 21 June 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Operative Neurosurgery Oxford University Press

In Reply: Navigation-Linked Heads-Up Display in Intracranial Surgery: Early Experience

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Publisher
Oxford University Press
Copyright
Copyright © 2018 by the Congress of Neurological Surgeons
ISSN
2332-4252
eISSN
2332-4260
D.O.I.
10.1093/ons/opy049
Publisher site
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Abstract

CORRESPONDENCE Disclosure In Reply: Navigation-Linked Heads-Up Display The authors have no personal, financial, or institutional interest in any of the in Intracranial Surgery: Early Experience drugs, materials, or devices described in this article. To the Editor: We thank Meola and Chang for their thoughtful and well- informed review of our manuscript “Navigation-Linked Heads- Justin R. Mascitelli, MD Up Display in Intracranial Surgery: Early Experience.” We Joshua B. Bederson, MD are in agreement that our study plus others in the literature Department of Neurosurgery demonstrate feasibility of use but not necessarily effectiveness Barrow Neurological Institute as judged by operative room efficiency and patient outcomes. Phoenix, Arizona In our experience, the major limitations are (1) a cumbersome Department of Neurosurgery setup for typically nonmicroscopic portions of the procedure (skin Mount Sinai Health System incision, soft tissue dissection, craniotomy, and dural opening); New York, New York (2) the distractibility of objects injected into the microscope and associated learning curve; and (3) loss of accuracy for REFERENCES deep lesions. Despite these limitations, the heads-up display, or 1. Meola A, Chang SD. Letter: Navigation-linked heads-up display in Intracranial augmented reality, can be immensely helpful in certain situations, surgery: early experience. Oper Neurosurg. 2018;14(6):E71–E72. for example in optimizing the approach and in determining the 2. Mascitelli JR, Schlachter L, Chartrain AG, et al. Navigation-linked heads- location of critical structures in real time before they are encoun- up display in intracranial surgery: early experience. Oper Neurosurg. 2017. published ahead of print October 10, 2017 (doi: 10.1093/ons/opx205). tered. Currently the technology is young and rapidly evolving. Future steps include evaluating its efficacy compared to standard cases, practically implementing the technology throughout an entire surgery, reducing distractibility, and developing methods to maintain accuracy and most importantly restoring accuracy 10.1093/ons/opy049 throughout the case. OPERATIVE NEUROSURGERY VOLUME 14 | NUMBER 6 | JUNE 2018 | E73 Downloaded from https://academic.oup.com/ons/article-abstract/14/6/E73/4953682 by Ed 'DeepDyve' Gillespie user on 21 June 2018

Journal

Operative NeurosurgeryOxford University Press

Published: Mar 24, 2018

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