Modified Taylor Retractor in Unilateral Subperiosteal Lumbar Microdiscectomy: A Frugal Alternative to the Tubular Retractor

2021 ◽  
Author(s):  
Jaskaran Singh Gosal ◽  
Jigish Ruparelia ◽  
Mayank Garg ◽  
Suryanarayanan Bhaskar ◽  
Surjit Singh ◽  
...  
Keyword(s):  
Tubular Retractor ◽  
Lumbar Microdiscectomy

scholarly journals The Learning Curve of Minimally-Invasive Lumbar Microdiscectomy

2008 ◽  
Vol 35 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Gregory S. McLoughlin ◽  
Daryl R. Fourney
Keyword(s):  
Minimally Invasive ◽  
Learning Curve ◽  
Operative Time ◽  
Controlled Trial ◽  
Lumbar Disc ◽  
Tubular Retractor ◽  
Lumbar Microdiscectomy ◽  
Randomized Controlled ◽  
Length Of Hospitalization ◽  
New Surgical Technique

Object:The safe integration into practice of a new surgical technique requires an appreciation of the learning curve. The object of this study was to assess the learning curve for minimally invasive microdiscectomy (MIM) utilizing a tubular retractor system.Methods:A prospective evaluation of a single surgeon's first 52 consecutive MIM cases for radiculopathy secondary to single-level posterolateral lumbar disc herniation was performed. The learning curve was assessed using operative time, conversion to open rate, complications, and length of hospitalization.Results:The duration of operative time decreased over the course of the study (range, 49-151 min). By case 15, operative time was typically 60 min or less. There was only one conversion to an open procedure (Case 2). Complications occurred in three cases. All but nine patients were discharged home on the day of surgery.Conclusion:The learning curve for MIM was demonstrated. Further assessment of this curve for a large group of surgeons is necessary before a randomized controlled trial comparing standard microdiscectomy to MIM can be conducted.

Minimally Invasive Lumbar Microdiscectomy using Tubular Retractor: A Preliminary Report

2005 ◽  
Vol 40 (6) ◽  
pp. 679 ◽  
Author(s):  
Yung Park ◽  
Joong Won Ha ◽  
Hyun Cheol Oh ◽  
Ju Hyung Yoo ◽  
Yun Tae Lee ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Preliminary Report ◽  
Tubular Retractor ◽  
Lumbar Microdiscectomy

scholarly journals How I do it: parietal trans-sulcal para-fascicular approach to lateral thalamic/internal capsule cavernous malformation

2021 ◽  
Author(s):  
Michael Amoo ◽  
Kieron J. Sweeney ◽  
Ronan Kilbride ◽  
Mohsen Javadpour
Keyword(s):  
White Matter ◽  
Cavernous Malformation ◽  
Internal Capsule ◽  
Complete Resection ◽  
Brain Lesions ◽  
Tubular Retractor ◽  
Surgical Technology ◽  
Feasible Alternative ◽  
Traditional Approaches ◽  
Deep Brain

Abstract Background The surgical management of deep brain lesions is challenging, with significant morbidity. Advances in surgical technology have presented the opportunity to tackle these lesions. Methods We performed a complete resection of a thalamic/internal capsule CM using a tubular retractor system via a parietal trans-sulcal para-fascicular (PTPF) approach without collateral injury to the nearby white matter tracts. Conclusion PTPF approach to lateral thalamic/internal capsule lesions can be safely performed without injury to eloquent white matter fibres. The paucity of major vessels along this trajectory and the preservation of lateral ventricle integrity make this approach a feasible alternative to traditional approaches.

scholarly journals MS-2 Minimally invasive glioma surgery with navigation system and tubular retractor

2020 ◽  
Vol 2 (Supplement_3) ◽  
pp. ii2-ii3
Author(s):  
Kazuhiko Kurozumi
Keyword(s):  
Navigation System ◽  
Diffusion Tensor ◽  
Therapeutic Option ◽  
Normal Brain ◽  
Navigation Systems ◽  
Glioma Surgery ◽  
Tubular Retractor ◽  
Neuronavigation System ◽  
Magnetic Resonance Imaging Mri ◽  
Neurological Surgery

Abstract Navigation systems are reliable and safe for neurological surgery. Navigation is an attractive and innovative therapeutic option. Recently, endo and exoscopic surgeries have been gradually increasing in neurosurgery. We are currently trialing to use 4K and 8K systems to improve the accuracy and safety of our surgical procedures. Surgeries for deep-seated tumors are challenging because of the difficulty in creating a corridor and observing the interface between lesions and the normal area. In total, 315 patients underwent surgery at Okayama University between 2017 and 2019. Among them, we experienced 92 glioma surgeries using navigation systems. Preoperatively, we performed computed tomography imaging and contrast-enhanced magnetic resonance imaging (MRI) for the neuronavigation system. We experienced Curve(TM) Image Guided Surgery (BrainLab, Munich, Germany). The surgical trajectory was planned with functional MRI and diffusion tensor imaging to protect the eloquent area and critical vasculature of the brain. We used a clear plastic tubular retractor system, the ViewSite Brain Access System, for surgery of deep seated gliomas. We gently inserted and placed the ViewSite using the neuronavigation. The tumor was observed and resected through the ViewSite tubular retractor under a microscope and endoscope. If the tumor was large, we switched the ViewSite tubular retractor to brain spatulas to identify the boundary between the normal brain and lesion. We are currently using the combination of the tubular retractor and brain spatulas using navigation system. Here, we present and analyze our preoperative simulation, surgical procedure, and outcomes.

scholarly journals Admission and Acute Complication Rate for Outpatient Lumbar Microdiscectomy

2010 ◽  
Vol 37 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Aria Fallah ◽  
Eric M. Massicotte ◽  
Michael G. Fehlings ◽  
Stephen J. Lewis ◽  
Yoga Raja Rampersaud ◽  
...  
Keyword(s):  
Complication Rate ◽  
Admission Rate ◽  
Complication Rates ◽  
Chi Square ◽  
Lumbar Microdiscectomy ◽  
Acute Complication ◽  
Admission Data ◽  
Improved Outcomes ◽  
Significant Difference ◽  
Revision Operations

Objective:Specialization is generally independently associated with improved outcomes for most types of surgery. This is the first study comparing the immediate success of outpatient lumbar microdiscectomy with respect to acute complication and conversion to inpatient rate. Long term pain relief is not examined in this study.Methods:Two separate prospective databases (one belonging to a neurosurgeon and brain tumor specialist, not specializing in spine (NS) and one belonging to four spine surgeons (SS)) were retrospectively reviewed. All acute complications as well as admission data of patients scheduled for outpatient lumbar microdiscectomy were extracted.Results:In total, 269 patients were in the NS group and 137 patients were in the SS group. The NS group averaged 24 cases per year while the SS group averaged 50 cases per year. Chi-square tests revealed no difference in acute complication rate [NS(6.7%), SS(7.3%)] (p>0.5) and admission rate [NS(4.1%), SS(5.8%)] (p=0.4) while the SS group had a significantly higher proportion of patients undergoing repeat microdiscectomy [NS(4.1%), SS(37.2%)] (p<0.0001). Excluding revision operations, there was no statistically significant difference in acute complication [NS(5.4%), SS(1.2%)] (p=0.09) and conversion to inpatient [NS(4.3%), SS(4.6%)] (p>0.5) rate. The combined acute complication and conversion to inpatient rate was 6.9% and 4.7% respectively.Conclusion:Based on this limited study, outpatient lumbar microdiscectomy can be apparently performed safely with similar immediate complication rates by both non-spine specialized neurosurgeons and spine surgeons, even though the trend favored the latter group for both outcome measures.

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