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neurosurgical_technique

Neurosurgical techniques

Surgery performed on the nervous system or its parts.

They require precise and dexterous manipulation of a surgical suture in narrow and deep spaces in the brain. This is necessary for surgical tasks such as the anastomosis of microscopic blood vessels and dura mater suturing.

Neurosurgical procedures lead to great psychological stress. In the past decade, several strategies and techniques have been implemented in order to minimize the patient's emotional stress 1) 2).

The esthetic aspect, not considered so important in the past, is now an important feature in the recovery and the quality of life in the postoperative period 3)

Types

Examples

Cranioplasty

Epilepsy surgery

Peripheral nerve field stimulation

Thermoablative procedure


Neurosurgical procedures are associated with unintentional damage to the brain during surgery, known as surgically induced brain injuries (SBI), which have been implicated in orchestrating structural and neurobehavioral deterioration.

Books

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This thoroughly revised and expanded atlas is the ideal reference for residents, fellows, and clinicians to review neurosurgical procedures before entering the OR. The authors provide step-by-step descriptions of techniques, clearly delineating indications and contraindications, goals, operative preparation and anesthesia, and postoperative management. The main focus of this book is on teaching neurosurgical techniques at the most detailed level.

Features of the second edition:

A new chapter on proton therapy An expanded section covering the latest radiosurgery techniques Nearly 3,000 high-quality images aid rapid comprehension of surgical procedures Online access to more than 100 surgical technique videos This book should be read cover to cover by young practitioners several times during their residency and it will keep more experienced neurosurgeons up-to-date on the latest surgical techniques in the field.

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Time-critical neurosurgical conditions require urgent operative treatment to prevent death or neurological deficits. In New South Wales/Australian Capital Territory patients' distance from neurosurgical care is often great, presenting a challenge in achieving timely care for patients with acute neurosurgical conditions.

A protocol was developed to facilitate consultant neurosurgery locally. Children with acute, time-critical neurosurgical emergencies underwent operations in hospitals that do not normally offer neurosurgery. The authors describe the developed protocol, the outcome of its use, and the lessons learned in the 9 initial cases where the protocol has been used. Three cases are discussed in detail.

Nine children were treated by a neurosurgeon at 5 rural hospitals, and 2 children were treated at a smaller metropolitan hospital. Road ambulance, fixed wing aircraft, and medical helicopters were used to transport the Newborn and Paediatric Emergency Transport Service (NETS) team, neurosurgeon, and patients. In each case, the time to definitive neurosurgical intervention was significantly reduced. The median interval from triage at the initial hospital to surgical start time was 3:55 hours, (interquartile range [IQR] 03:29-05:20 hours). The median distance traveled to reach a patient was 232 km (range 23-637 km). The median interval from the initial NETS call requesting patient retrieval to surgical start time was 3:15 hours (IQR 00:47-03:37 hours). The estimated median “time saved” was approximately 3:00 hours (IQR 1:44-3:15 hours) compared with the travel time to retrieve the child to the tertiary center: 8:31 hours (IQR 6:56-10:08 hours).

Remote urgent neurosurgical interventions can be performed safely and effectively. This practice is relevant to countries where distance limits urgent access for patients to tertiary pediatric care. This practice is lifesaving for some children with head injuries and other acute neurosurgical conditions 4).

1)
Angelini GD, Butchart EG, Armistead SH, Breckenridge IM. Comparative study of leg wound skin closure in coronary artery bypass graft operations. Thorax. 1984;39:942–5.
2)
Bekar A, Korfali E, Dogan S, Yilmazlar S, Baskan Z, Aksoy K. The effect of hair on infection after cranial surgery. Acta Neurochir (Wien) 2001;143:533–6. discussion 537.
3)
Cho J, Harrop J, Veznaedaroglu E, Andrews DW. Concomitant use of computer image guidance, linear or sigmoid incisions after minimal shave, and liquid wound dressing with 2-octyl cyanoacrylate for tumor craniotomy or craniectomy: Analysis of 225 consecutive surgical cases with antecedent historical control at one institution. Neurosurgery. 2003;52:832–40. discussion 840-1.
4)
Owler BK, Carmo KA, Bladwell W, Fa'asalele TA, Roxburgh J, Kendrick T, Berry A. Mobile pediatric neurosurgery: rapid response neurosurgery for remote or urgent pediatric patients. J Neurosurg Pediatr. 2015 Sep;16(3):340-5. doi: 10.3171/2015.2.PEDS14310. Epub 2015 Jun 19. PubMed PMID: 26090548.
neurosurgical_technique.txt · Last modified: 2017/02/21 16:28 by 212.163.6.22