Download Advanced Intraoperative Technologies in Neurosurgery by R. E. Anderson, J. E. Boggan, L. J. Cerullo, M. C. Chan, G. PDF

By R. E. Anderson, J. E. Boggan, L. J. Cerullo, M. C. Chan, G. J. Dohrmann, M. S. B. Edwards, V. A. Fasano, J. M. Gilsbach, A. Harders, R. M. Ikeda, P. J. Kelly, E. R. Laws Jr., G. Lee, T. Letardi, D. T. Mason, C. R. Neblett, R. W. Rand, A. Renieri, I. L. Ri

Since the creation of electrosurgery the concepts of surgical procedure at the worried procedure have gone through extra advancements (bipolar coagulation, microscope), no matter if the process used to be now not considerably converted. this present day, laser represents a brand new "discipline", because it bargains a brand new means of acting all easy maneuvers (dissection, demolition, hemostasis, vessel sutures). moreover, laser deals the potential for a different maneuver, specifically aid of the amount of a tumoral mass via vaporization. Its software isn't really constrained to standard neurosurgery yet extends additionally to stereotactic and vascular neurosurgery. Laser surgical procedure has additionally prompted the anesthesiologic suggestions. while new instrumentation has been brought: CUSA ultrasonic aspiration, echotomography, and Doppler flowmeter. i've got had the opportunity to make use of those new applied sciences all at a time and feature come to the belief that we face the sunrise of a brand new method which has already proven its validity and absence of inconveniences, and whose item is to extend the precision of neurological surgical procedure. The technological improvement remains to be happening, and a few advancements are to be foreseen. Laser scalpel is splitting the preliminary laser surgical procedure into NO­ contact and contact surgical procedure with laser. As new instrumentarium could be built, a variable and tunable beam turns into to be had. for instance, in many years unfastened Electron Laser will extra upload to the growth during this field.

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The •• Fig. 2. The present appearance of the microvascular Doppler system with a built in spectrum analyzer (EME, Uberlingen, Germany) Table 1. 1 kHz transcutaneous application was restricted to superficial vessels because of the low penetration depth (in clinical practice not more than 5 mm). For recordings in the basal cisterns, the pulsed system helped to exclude other vessels commonly lying in the same direction in the ultrasonic beam. Because of the relatively large sample volume in comparison with vessels Intraoperative Dopplersonography 33 having diameters of 1 mm no reliable flow profiles or exact center stream measurements could be performed.

Lombard, G. , Ponzio, R. , Lanotte, M. : The use of laser and CUSA in the treatment of brain stem tumors. 26 3. 4. 5. 6. 7. 8. 9. 10. V. A. Fasano: Intraoperative A-Mode Echoencephalography International Symposium on Surgery in and around the brain stem and the third ventricle. Hannover, February 18-23, 1985. In press. French, L. , Wild, 1. , 1950: Detection of cerebral tumors by ultrasonic pulses: Pilot studies on postmortem material. Cancer 3, 705-708. French, L. , Wild, J. , 1951: The experimental application of ultrasonics to localization of brain tumors: Preliminary report.

Gilsbach and A. Harders: velocities were more or less generalized and not circumscribed (Fig. 13). We interpreted this as low resistance due to the acute bleeding and/or lowered intracranial pressure during operation. Angioma Cases High flow velocities with a relatively high diastolic flow component were typical for vessels which feed an angioma or a fistula. Depending on the caliber of the vessel and the flow volume, the flow pattern varied from accelerated forms to irregular types (Fig. 14). In these cases, the limits of the Doppler system were reached because the velocities were higher than the device was able to record.

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