Neurosurgical tools and techniques--modern image-guided surgery.

Cushing and other great neurosurgeons made their mental preparations for surgical procedures through extensive, beautiful drawings. Three-dimensional visualization was in those days supported through interpretation of pneumoencephalograms with displacements of structures indicating where a space-occupying process might be located. Today this visualization necessary for each neurosurgeon is partly lost in the teaching process due to axial magnetic resonance imaging and computed tomography scans and of minimal invasive techniques. Microsurgical navigation on the brain surface is like sailing along a coastline. Navigating in the brain is like sailing in fog and tools for navigation must be developed accordingly. The robotic microscope Surgiscope enables the surgeon to have at the same time a microscope, a pointing devise and a bidirectional tool for automatic maneuverability in the brain. A neurosurgeon may be distracted and thereby perform less adequate. Computer technology and virtual reality models enhances possibilities for rehearsal of difficult operations and of controlling the surgical performance. Computer technology is thus a supporter of future neurosurgeons and a part of quality control. Future education must be linked to this fact.