ORIGINAL RESEARCH article
Front. Surg.
Sec. Neurosurgery
This article is part of the Research TopicImproving neurosurgical precision: leveraging technology for enhanced visualization and navigation of complex neuroanatomyView all 11 articles
Minimal Invasive Approaches using Virtual Reality Planning in Elective Aneurysm Surgery
Provisionally accepted
Ladina Aurea Greuter1,2*
Tabea Stoessel2Florian Ebel2Emilia Westarp2
Attill Saemann2Jonathan Rychen2Philippe Cattin3Marek Zelechowski3Balasz Faludi3
Jehuda Soleman1,2,4
Raphael Guzman1,2,4- 1University Hospital of Basel, Basel, Switzerland
- 2Universitatsspital Basel Klinik fur Neurochirurgie, Basel, Switzerland
- 3Center for Medical Image Analysis & Navigation (CIAN), University of Basel, Basel, Switzerland
- 4Universitat Basel Medizinische Fakultat, Basel, Switzerland
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract Introduction While endovascular treatment (EVT) has gained popularity for its minimally invasive approach, microsurgical clipping for unruptured intracranial aneurysms (UIAs) has also evolved using surgical adjuncts such as virtual reality (VR) and keyhole techniques to enhance patient outcome. Immersive 3D VR images allow for the creation of an accurate 3D anatomical model, making it a valuable tool for surgical planning. This study investigated the impact of VR-based surgical planning on approach type and craniotomy size. Methods This retrospective cohort study included all elective microsurgical clipping for UIAs from 1.1.2009 to 31.12.2024 at the University Hospital of Basel, Switzerland, and was approved by the local ethics board. Demographic, surgical, and outcome parameters were collected. SpectoMedical®, developed at the University of Basel, was the VR platform used. The primary outcome was craniotomy size [cm2] measured with the AC method. Descriptive and comparative statistics were conducted. To asses factors influencing the craniotomy size, we calculated a multivariable linear regression model. Results We included a total of 163 aneurysms in 159 patients with a mean age of 58.52 (±10.23) and 114 (69.9%) females. VR-based surgical planning resulted in a significantly smaller craniotomy size (no VR vs. VR, 20.31 (±19.21) cm2 vs. 13.22 (±7.85) cm2, p=0.007) and shorter hospital stay ((no VR vs. VR, 10.04 (±5.58) vs. 7.89 (±2.79) days, p=0.031). Operative time was shorter in the VR group, but lacked statistical significance (no VR vs. VR, 226.41 (±86.18) minutes vs. 207.93 (±54.92) minutes, p=0.160). A multivaraible regression model showed that the use of VR-based surgical planning reduced the craniotomy size by 6.2 cm2. Conclusion VR-based surgical planning was associated with significantly smaller craniotomy sizes and shorter hospital stays. It results in an intraoperative déjà-vu effect for the surgeon which support its use as a valuable adjunct in preoperative planning,
Keywords: virtual reality, aneurysm surgery, Neurovascular surgery, Minimal invasive approach, Specto
Received: 25 Sep 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Aurea Greuter, Stoessel, Ebel, Westarp, Saemann, Rychen, Cattin, Zelechowski, Faludi, Soleman and Guzman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Ladina Aurea Greuter, ladina.greuter@unibas.ch
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.