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Craniotomy on camera

“Remove the bone, let the brain alone”

Published onNov 14, 2023
Craniotomy on camera


At the master table, two prominent neurosurgeons, PV and Andreas Raabe, are relaying each other to demonstrate the first exercise: a simple craniotomy. Their hands are followed by a camera plugged into a huge 4K 3D display. The image from the microscope is also relayed in a big screen. This is the very beginning: performing an opening in the skull is relatively basic knowledge, the instructions have been delivered already by Peter Vajkoczy in the previous lecture: “remove the bone, leave the brain alone,” he quotes from one of his American heroes. The opening has to be generous enough to enable the right access, despite the random factor of various “shifts” that can happen when the pressure in the skull is released. He has already warned the trainees of some of the common pitfalls: “Here, when you come up to the pterion [a landmark at the juncture of three sutures] then beginners often do an opening that has a sharp angle. It’s impossible to operate the microscope when you have to intervene at this spot. In consequence, always cut a 90-degree angle.”

The surgeon is quite excited in experiencing the prepared tissues under the bone. They are quite impressed with the new technology, and on the screen, the brains appear as shiny and lively as it usually does during their clinical work. It feels “as if it was the real thing,” Peter Vajkoczy says to me, as he walks away from the scene. But aren’t they the real thing? It takes me a while to process. “Do you mean that they feel as if it was living tissues?” “Yes, exactly,” he tells me, before hopping off to the next table.

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