Evidence map›Paper›PMID 39958370›Full record

ArticleNeurosurgery practice2023

The "Canopy Approach": Case Series Using Immersive Virtual Reality for Bottom-Up Target-Based Preoperative Planning in Pediatric Neurosurgery.

Grace Y Lai, Ryan R L Phelps, Nilika S Singhal, Joseph E Sullivan, Adam L Numis, Kurtis I Auguste

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Article in Neurosurgery practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Grace Y LaiDepartment of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.ORCID https://orcid.org/0000-0001-7560-400X
Ryan R L PhelpsDepartment of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.
Nilika S SinghalDepartment of Neurology, University of California San Francisco, San Francisco, California, USA.
Joseph E SullivanDepartment of Neurology, University of California San Francisco, San Francisco, California, USA.
Adam L NumisDepartment of Neurology, University of California San Francisco, San Francisco, California, USA.
Kurtis I AugusteDepartment of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVirtual reality (VR) is increasingly used for trajectory planning in neurosurgery.

objectiveTo describe a case series showing the application of immersive VR involving both "top-down" from skull to lesion and "bottom-up" from lesion to skull approaches for trajectory planning in pediatric neurosurgical patients.

methodsWe detail the preoperative and intraoperative application of VR and clinical courses of 5 children (aged 7-14 years) with anatomically challenging intraparenchymal lesions that posed operative risks to nearby vascular anatomy and fiber tracts. Preoperative planning consisted of standard presurgical evaluation with computed tomography and magnetic resonance imaging used to render 3-dimensional models that could be viewed and manipulated using desktop software and immersive VR headsets and hand controllers by the surgeon and family. Patient satisfaction was evaluated by survey. Surgical outcomes were degree of seizure control or extent of resection.

resultsThree patients underwent lesion resection and 2 laser ablation. Modifications to 2-dimensional and "top-down" VR trajectory plans were made after "bottom-up" navigation in all cases. All families reported that the VR enhanced their understanding of the procedure. There were no complications, and no patients suffered permanent neurological deficits postoperatively. Gross total resection was achieved in all lesional cases, and patients with epilepsy achieved seizure freedom at 2 years postoperatively.

conclusionImmersive VR allows operative corridors to be virtually traveled and viewed from a "top-down" and "bottom-up" perspective, as if looking up from under a forest canopy of overlying anatomy, for optimal trajectory planning and improvement of family understanding in pediatric neurosurgery.

Indexed as

Pediatric brain tumorPediatric epilepsy surgeryPediatric neurosurgeryPreoperative planningVirtual reality

Identifiers

PMID39958370
PMCPMC11809979

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.