A Simple Modified Technique for Frameless Brain Lesion Biopsy.

Published articles pertaining to possible ways to increase the accuracy of image-guided frameless surgery are abundant in the literature. Accurate target localization is dependent on many factors, of which noteworthy is the meticulous registration and constant fixation of instruments during the procedure. Frequent changing of instruments' application or inadvertent destabilization of its fixation during surgery after registration might disrupt the preset navigation measurements, leading to inaccurate targeting. Technical wise, we managed to avoid the drawback of moving the aiming device repeatedly during the procedure, as we will discuss later. This retrospective study aims to evaluate the feasibility and reliability of a simple frameless technique we used in navigation-guided brain biopsy and to show how it refines the accuracy of frameless biopsy procedures. All procedures were performed at our institution in the period from 2018 to 2019 and included 10 patients with different brain lesions. The mean operative time using our technique was noticeably short (18 minutes) and the standard deviation was 2.1. The used technique was easy, undemanding, and reliable in obtaining samples from brain tumors, guaranteeing more precision by applying an all-time fixed and stable navigation reference hardware.