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October 26, 1984

Neurological Surgery

JAMA. 1984;252(16):2232-2234. doi:10.1001/jama.1984.03350160100029

New technology continues to make a heavy impact on contemporary neurosurgery. In retrospect, modern neurosurgery probably dates to about 15 years ago, when the operating microscope came into wide use and provided the magnification and lighting necessary to operate on small structures in the head and spinal canal. Technology has continued to advance, and neurosurgeons now are exploring new tools, including the laser, the ultrasonic aspirator, and the use of ultrasonic brain scanning in the operating room to identify lesions deep in the brain.

The most popular laser in neurosurgery is the carbon dioxide laser. The laser beam is directed by a series of mirrors in an articulated arm into the operating microscope and into the operating field. The surgeon can move the spot of light energy about the field using a joystick, and when the spot is centered on the target, usually a tumor, the laser is energized by