Acta Neurochirurgica. 2026;168:136
Objective
To determine whether supervised resident participation affects the safety or perioperative performance of stereotactic brain biopsy.
Methods
Bicentric retrospective study of 217 frame-based or navigated frameless biopsies. Faculty neurosurgeons performed 157 procedures, while supervised residents performed 60.
Main results
Resident participation was not associated with an increase in intraoperative or postoperative complications. Teaching cases—particularly frame-based procedures—required longer operative and anesthesia times. Frameless navigation appeared easier to integrate into early resident training. The study was underpowered to exclude modest differences in rare complications.
Interpretation
Structured, closely supervised participation allows residents to learn stereotactic biopsy without an evident deterioration in patient safety. The additional operative time represents the principal measurable cost of teaching.
Limitations
Retrospective design, low event rates and incomplete information regarding the resident’s precise contribution. Teaching and faculty groups also differed in patient age and case selection.
Clinical takeaway
Stereotactic biopsy can be incorporated safely into residency training when supervision, procedural standardization and appropriate case selection are maintained.
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