scholarly journals How to iGuide: flat panel detector, CT-assisted, minimally invasive evacuation of intracranial hematomas

2021 ◽  
pp. neurintsurg-2021-017903
Author(s):  
David Dornbos III ◽  
Cathra Halabi ◽  
Julie DiNitto ◽  
Kerstin Mueller ◽  
David Fiorella ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Needle Guidance ◽  
Flat Panel ◽  
Neurologic Recovery ◽  
Flat Panel Detector ◽  
Minimally Invasive Surgical ◽  
Intracranial Hematomas ◽  
Navigation Accuracy ◽  
High Degree ◽  
Minimally Invasive Methods

Evidence is growing to support minimally invasive surgical evacuation of intraparenchymal hematomas, particularly those with minimal residual hematoma volumes following evacuation. To maximize the potential for neurologic recovery, it is imperative that the trajectory for access to the hematoma minimizes disruption of normal parenchyma. Flat panel detector CT-based navigation and needle guidance software provides a platform that uses flat panel detector CT imaging obtained on the angiography table to aid reliable and safe access to the hematoma. In addition to providing a high degree of accuracy, this method also allows convenient and rapid re-imaging to assess navigation accuracy and the degree of hematoma evacuation prior to procedural completion. We provide a practical review of the syngo iGuide needle guidance software and the methodology for incorporating its use, and the software of other vendors, in a variety of minimally invasive methods for evacuation of intraparenchymal hematomas.

scholarly journals Diagnosis and Surgical Treatment of Traumatic Intracranial Hematomas in Young Children

2021 ◽  
pp. 1-7
Author(s):  
Igor Ivanovich Larkin ◽  
Igor Ivanovich Larkin ◽  
Valeriy Ivanovich Larkin ◽  
Tadeush Petrovich Milcharek ◽  
Svetlana Yurievna Vegner ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Young Children ◽  
Minimally Invasive ◽  
Pediatric Neurosurgery ◽  
Volume Index ◽  
Minimally Invasive Surgical ◽  
Surgical Methods ◽  
Intracranial Hematomas ◽  
Surgical Tactics ◽  
Group B

Objective: To improve the treatment of young children with traumatic intracranial hematomas by improving the diagnosis and use of minimally invasive surgical methods based on calculations of the intracranial hematoma volume index (VICH). Subjects and Methods: An analysis of the clinical course as well as the surgical treatment of 111 patients was carried out. The patients were under the age of 3, with severe traumatic brain injury, and formation of intracranial hematomas. The children were treated at the Department of Pediatric Neurosurgery of the City Children’s Clinical Hospital No.3 in Omsk, Russia, from 2008 to 2018. Three groups were identified: Group A - children with epidural hematomas (n=30), Group B - children with subdural hematomas (n=43), Group C - children with multiple hematomas (n=38). The volume index of intracranial hematomas (VICH) was calculated, and the surgical tactics were determined based on the value of the VICH. Results: Children with a VICH less than 2% received conservative treatments. Those with a VICH from 2 to 4% were treated with minimally invasive methods (puncture, drainage). Children with VICH above 4% underwent decompressive surgery. Conclusion: The effectiveness of the developed differentiated tactics of treatment of young children with traumatic intracranial hematomas (ICH) is characterized by a decrease in the risk of an unfavourable outcome by 74.2% and mortality by 1.2%.

Volume CT with a flat-panel detector on a mobile, isocentric C-arm: Pre-clinical investigation in guidance of minimally invasive surgery

2005 ◽  
Vol 32 (1) ◽  
pp. 241-254 ◽  
Author(s):  
J. H. Siewerdsen ◽  
D. J. Moseley ◽  
S. Burch ◽  
S. K. Bisland ◽  
A. Bogaards ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Clinical Investigation ◽  
Flat Panel ◽  
Flat Panel Detector ◽  
Volume Ct

Considerations in Dysphagia Management Following Esophagectomy

2016 ◽  
Vol 1 (13) ◽  
pp. 169-176
Author(s):  
Lisa M. Evangelista ◽  
James L. Coyle
Keyword(s):  
Esophageal Cancer ◽  
Minimally Invasive ◽  
Minimally Invasive Surgical Procedures ◽  
Esophageal Resection ◽  
Minimally Invasive Surgical ◽  
Operative Complications ◽  
Swallowing Difficulties ◽  
Epidemiological Impact ◽  
Invasive Techniques ◽  
Management Of Dysphagia

Esophageal cancer is the sixth leading cause of death from cancer worldwide. Esophageal resection is the mainstay treatment for cancers of the esophagus. While curative, surgical resection may result in swallowing difficulties that require intervention from speech-language pathologists (SLPs). Minimally invasive surgical procedures for esophageal resection have aimed to reduce morbidity and mortality associated with more invasive techniques. Both intra-operative and post-operative complications, regardless of the surgical approach, can result in dysphagia. This article will review the epidemiological impact of esophageal cancers, operative complications resulting in dysphagia, and clinical assessment and management of dysphagia pertinent to esophageal resection.

Noninvasive patient tracker mask for spinal 3D navigation: does the required large-volume 3D scan involve a considerably increased radiation exposure?

2020 ◽  
Vol 33 (6) ◽  
pp. 838-844
Author(s):  
Jan-Helge Klingler ◽  
Ulrich Hubbe ◽  
Christoph Scholz ◽  
Florian Volz ◽  
Marc Hohenhaus ◽  
...  
Keyword(s):  
Radiation Exposure ◽  
Image Data ◽  
3D Image ◽  
Flat Panel ◽  
3D Navigation ◽  
Data Set ◽  
Dose Area Product ◽  
Flat Panel Detector ◽  
3D Scan ◽  
Area Product

OBJECTIVEIntraoperative 3D imaging and navigation is increasingly used for minimally invasive spine surgery. A novel, noninvasive patient tracker that is adhered as a mask on the skin for 3D navigation necessitates a larger intraoperative 3D image set for appropriate referencing. This enlarged 3D image data set can be acquired by a state-of-the-art 3D C-arm device that is equipped with a large flat-panel detector. However, the presumably associated higher radiation exposure to the patient has essentially not yet been investigated and is therefore the objective of this study.METHODSPatients were retrospectively included if a thoracolumbar 3D scan was performed intraoperatively between 2016 and 2019 using a 3D C-arm with a large 30 × 30–cm flat-panel detector (3D scan volume 4096 cm3) or a 3D C-arm with a smaller 20 × 20–cm flat-panel detector (3D scan volume 2097 cm3), and the dose area product was available for the 3D scan. Additionally, the fluoroscopy time and the number of fluoroscopic images per 3D scan, as well as the BMI of the patients, were recorded.RESULTSThe authors compared 62 intraoperative thoracolumbar 3D scans using the 3D C-arm with a large flat-panel detector and 12 3D scans using the 3D C-arm with a small flat-panel detector. Overall, the 3D C-arm with a large flat-panel detector required more fluoroscopic images per scan (mean 389.0 ± 8.4 vs 117.0 ± 4.6, p < 0.0001), leading to a significantly higher dose area product (mean 1028.6 ± 767.9 vs 457.1 ± 118.9 cGy × cm2, p = 0.0044).CONCLUSIONSThe novel, noninvasive patient tracker mask facilitates intraoperative 3D navigation while eliminating the need for an additional skin incision with detachment of the autochthonous muscles. However, the use of this patient tracker mask requires a larger intraoperative 3D image data set for accurate registration, resulting in a 2.25 times higher radiation exposure to the patient. The use of the patient tracker mask should thus be based on an individual decision, especially taking into considering the radiation exposure and extent of instrumentation.

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