Minim Invas Neurosur
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Minim Invas Neurosur · Aug 2007
Case ReportsCombined endoscopically guided third ventriculostomy with prepontine cistern placement of the ventricular catheter in a ventriculo-peritoneal shunt: technical note.
The authors present the management of non-obstructive hydrocephalus using two surgical procedures, both at the same time: first, we perform an endoscopic third ventriculostomy and second, we place the ventricular catheter of the ventriculo-peritoneal shunt in the prepontine cistern under endoscopic guidance. The main rationale is the fact that the ventricular catheter passes through multiple fixed cerebrospinal fluid circulation points in order to allow the free circulation of the cerebrospinal liquid. The authors present here details of the technique and short-term results.
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Minim Invas Neurosur · Aug 2007
Pterional keyhole approach to middle cerebral artery aneurysms through an outer canthal skin incision.
The supraorbital keyhole approach via an eyebrow skin incision provides a method for the minimally invasive clipping of aneurysms located in the circle of Willis, but has disadvantages for aneurysms located in the lateral Sylvian fissure. The pterional keyhole minicraniotomy via an outer canthal skin incision is proposed for the clipping of unruptured aneurysms of the middle cerebral artery (MCA). ⋯ The pterional keyhole approach via outer an canthal skin incision is another treatment option for relatively small, unruptured MCA aneurysms.
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Minim Invas Neurosur · Aug 2007
Multiple brain tumor nodule resections under direct visualization of a neuronavigated endoscope.
With neuronavigation-assistance, endoscopic neurosurgery has a variety of advantages for brain tumor resection. However, intraoperative neuronavigation has to be operated by frequently alternating a neuronavigation wand and moving the microscope back-and-forth on the surgical field while the microscope is being used for surgery, except when using stereo overlays in the operating microscope aligned to the operative scene. In our practice, our surgical endoscope was used as a sole optical device and was also calibrated as a virtual wand targeting to tumor nodules while the operation was being performed under its simultaneous visualization. This paper gives a brief description and technical report of applications of image-guided endoscopy in two cases with multiple tumor nodules. ⋯ The neuronavigated endoscope coordinates of the tip of endoscope, and the trajectory of targets, provide both 3D orientation and direct endoscopic visualization simultaneously, and present with the unique feature for solely endoscopic minimally invasive procedures, especially for multiple intracranial lesions.
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Minim Invas Neurosur · Jun 2007
ReviewBalloon-assisted endoscopic retroperitoneal gasless approach (BERG) for lumbar interbody fusion: is it a valid alternative to the laparoscopic approach?
In the last years the use of interbody fusion devices with an anterior spinal lumbar approach has become a common procedure for the treatment of degenerative disc disease and spinal instability. We analysed our series of a simplified endoscopic approach to the anterior spine and made a review of the retroperitoneal endoscopically assisted approach to the anterior lumbar spine in the international literature. ⋯ The BERG technique is a safe, effective, simplified, less technically demanding alternative approach when performing ALIF procedures, without the morbidity associated with laparoscopic or traditional approaches.
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Minim Invas Neurosur · Jun 2007
Case ReportsImage-guided microneurosurgical management of small arteriovenous malformation: role of neuronavigation and intraoperative Doppler sonography.
The goal of this study was to evaluate the efficacy and reliability of neuronavigation and intraoperative microvascular Doppler sonography (MDS) for identifying afferent (feeding) and efferent (draining) vessels as well as for controlling the totality of the surgical resection of arteriovenous malformations (AVMs). ⋯ Image-guided microneurosurgery with intraoperative MDS is a safe, effective, and reliable method for identifying the afferent and efferent vessels and for confirming the complete resection of AVMs. These benefits of image-guided microsurgery were most apparent for small, deep-seated AVMs that were not visible on the surface of the brain. In addition these techniques reduce the operative time and blood loss during AVM resection.