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  • Analysis of surgical precision and efficiency (Biometrics) in resection of intracranial neoplasms.

    Final Number:

    Ritesh Kumar MD; Fahad A. Alkherayf MD, MSc, CIP, FRCSC; Mohamed Labib MD; Amin B. Kassam MD

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2013 Annual Meeting

    Introduction: Surgical biometrics is the process of examining and measuring the delivery of precision therapy in an efficient manner with the goal being to reduce the cost of patient morbidity and improve patient outcomes (precision) while optimizing the economics of resource expenditure and utilization (efficiency).

    Methods: A series of neurosurgical procedures including minimally invasive and conventional approaches were studied. Core components of each phase of surgery were examined for both precision and efficiency. These components were divided into the approach (exposure required to get from the external environment to the region of interest adjacent to the target), cytoreduction (removal of target tissue while preserving surrounding neurovascular tissue) and reconstruction (of both the external and internal corridor used in the approach). During each procedure a series of biometric data (time, automation, manual and component) were independently collected conterminously. The data was then converted using mathematical modeling into graphical representation and was subsequently analysed. Procedures were clustered based on general considerations to the degree possible; open vs. MIS (minimally invasive surgery), tumour type and comparison.

    Results: During each phase of the procedure the ration of automation to manual represented the most significant factor that determined efficiency of the procedure. During the microdissection phase there was generally very little automation used. During the resection phase the slope of the curve of automation vs manual determined the efficiency. The attached figure demonstrates that if the slope is negative (red curve) as opposed to positive (yellow curve), greater efficiency is realized.

    Conclusions: Neurosurgical procedures, like other specialties, may be more efficient when automated instrumentation can be utilized. This efficiency can be quantified and the value added can generally be calculated. However, we do accept that automation may not always be possible.

    Patient Care: By analyzing efficiency and precision in surgical technique, patient care can be improved with decreased surgical time without sacrificing safety.

    Learning Objectives: 1) To describe and discuss the concept of surgical biometrics. 2) To discuss the value of analyzing biometircs. 3) To discuss the value of Minimally Invasive Surgery in surgical biometrics.


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