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Spectroscopy in the Operating Theatre – A Surgeon’s View
Ioannis Vasilikos
Universitätsklinikum Freiburg, Germany
Advances in intraoperative imaging have reshaped neurosurgical precision, yet real‑time molecular feedback remains underutilized. In this keynote, we explore three surgical scenarios where spectroscopy could markedly enhance decision‑making and patient outcomes. First, during glioblastoma resection, distinguishing infiltrative tumor margins from eloquent cortex is challenging; intraoperative Raman or fluorescence spectroscopy promises to delineate residual neoplastic tissue beyond the resolution of visual inspection and neuronavigation. Second, in intramedullary spinal tumor surgery, continuous neurophysiological monitoring guides functional preservation, but lacks biochemical insight; combining spectroscopy with somatosensory and motor‑evoked potentials could detect early metabolic alterations in cord tissue, preempting irreversible injury. Third, in vascular neurosurgery—such as aneurysm clipping and arteriovenous malformation resection—spectroscopic measurement of ischemic metabolites (lactate, cytochrome redox state) could provide an immediate alert to compromised perfusion before clinical or Doppler changes arise. Collectively, these examples illustrate how integrating spectroscopy into the operating theatre may transform neurosurgical practice by delivering real‑time molecular intelligence, improving margin control, safeguarding neural function, and optimizing vascular safety.
