The term frameless stereotactic surgery has been used to describe such systems. There is no limit to the benefits that image-guidance provides. Traditionally, every neurosurgeon already performs this task mentally, without the help of computer systems. We are trained to study the preoperative imaging information, and translate such data to the operating room using our own knowledge of surgical anatomy. Stereotactic frame systems provide excellent surgical guidance.
Localization is highly accurate, precise, and reproducible.
There are many reports of the use of stereotactic systems for mass lesion localization at craniotomy. However, such frame systems have not attained universal usage due to the increased time and effort necessary in their use. In most centers, a frame must be applied to the head, the patient transferred to a radiology suite where CT or MR imaging is performed, the patient must be taken back to the operating room, and then localization performed using stereotactic tools. Many feel that the frame restricts access to placement of the skin incision and bone flap. Despite such limitations, and the availability of an intraoperative CT scan at the University of Pittsburgh, we have used stereotactic frame guidance at craniotomy since 1981 and found it to be user-friendly and accurate.