scholarly journals Minimally invasive surgery and transsulcal parafascicular approach in the evacuation of intracerebral haemorrhage

2019 ◽  
Vol 5 (1) ◽  
pp. 40-49
Author(s):  
Lina Marenco-Hillembrand ◽  
Paola Suarez-Meade ◽  
Henry Ruiz Garcia ◽  
Ricardo Murguia-Fuentes ◽  
Erik H Middlebrooks ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intracerebral Haemorrhage ◽  
Small Diameter ◽  
Substantial Improvement ◽  
Brain Parenchyma ◽  
Anatomical Dissection ◽  
Surgical Manipulation

Intracerebral haemorrhage (ICH) describes haemorrhage into the brain parenchyma that may result in a decline of the patient’s neurological function. ICH is a common cause of morbidity and mortality worldwide. Aggressive surgical treatment for ICH has remained controversial as clinical trials have failed to demonstrate substantial improvement in patient outcome and mortality. Recently, promising mechanical and pharmacological minimally invasive surgery (MIS) techniques for the treatment of ICH have been described. MIS was designed with the objective of reducing morbidity due to complications of surgical manipulation. Mechanical MIS includes the use of tubular retractors and small diameter instruments for ICH removal. Pharmacological methods consist of catheter placement inside the haematoma cavity for the passive drainage of the haematoma over the course of several days. One of the most favourable approaches for MIS is the use of natural corridors for reaching the lesion, such as the transsulcal parafascicular approach. This approach provides an anatomical dissection of the subjacent white matter tracts, causing the least amount of damage while evacuating the haematoma. A detailed description of the currently known MIS techniques and devices is presented in this review. Special attention is given to the transsulcal parafascicular approach, which has particular benefits to provide a less traumatic MIS with promising overall patient outcome.

scholarly journals Minimally invasive surgery for intracerebral haemorrhage

2014 ◽  
Vol 20 (2) ◽  
pp. 148-152 ◽  
Author(s):  
Benjamin Barnes ◽  
Daniel F. Hanley ◽  
Juan R. Carhuapoma
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intracerebral Haemorrhage

scholarly journals Design and development of sensorless based 5-DOF bilaterally controlled surgical manipulator: A prototype

2021 ◽  
Vol 10 (2) ◽  
pp. 619-631
Author(s):  
Sakol Nakdhamabhorn ◽  
M. Branesh Pillai ◽  
Jackrit Suthakorn
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Force Feedback ◽  
Reaction Force ◽  
Motion Error ◽  
Hand Dexterity ◽  
Internal Disturbance ◽  
Surgical Manipulation ◽  
Surgical Manipulator

Minimally invasive surgery (MIS) is one of the most challenging tasks in surgical procedures due to the lack of visibility of the surgical area, instrument orientation, and depth perception. A tele-operated robot assisted minimally invasive surgery is developed to enhance a surgeon's hand dexterity and accuracy. To perform MIS, the surgeon controls a slave manipulator via a master manipulator, so the force feedback and motion feedback are required to imitate an amount of action and reaction force between master and slave manipulator. The complicated MIS requires more complex surgical manipulator with multi DOFs and multiple force feedback. The limitation of multiple DOFs force feedback is a bandwidth of torque sensors. Therefore, this study proposes a sensorless based 5-DOF Bilaterally controlled surgical manipulation. In this research disturbance observer (DOB) is used to identify the internal disturbance of the system, which is used to estimate the reaction torque. This research mainly focuses on a 5-DOF bilaterally controlled surgical manipulator to maintain a position and additional force. The result of torque error in contact motion is less than 2%, the non-contact motion error is not over 5%, and it is evident that the error is always less than 0.3% for the position response.

scholarly journals Variation in medical management and neurosurgical treatment of patients with supratentorial spontaneous intracerebral haemorrhage

2021 ◽  
pp. 239698732110059
Author(s):  
Lotte Sondag ◽  
Floor AE Jacobs ◽  
Floris HBM Schreuder ◽  
Jeroen D Boogaarts ◽  
W Peter Vandertop ◽  
...  
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intracerebral Haemorrhage ◽  
Online Survey ◽  
Treatment Decisions ◽  
Neurosurgical Treatment ◽  
The Right ◽  
Invasive Techniques ◽  
Spontaneous Intracerebral Haemorrhage

Introduction The role of surgery in spontaneous intracerebral haemorrhage (sICH) remains controversial. This leads to variation in the percentage of patients who are treated with surgery between countries. Patients and methods We sent an online survey to all neurosurgeons (n = 140) and to a sample of neurologists (n = 378) in Dutch hospitals, with questions on management in supratentorial sICH in general, and on treatment in six patients, to explore current variation in medical and neurosurgical management. We assessed patient and haemorrhage characteristics influencing treatment decisions. Results Twenty-nine (21%) neurosurgeons and 92 (24%) neurologists responded. Prior to surgery, neurosurgeons would more frequently administer platelet-transfusion in patients on clopidogrel (64% versus 13%; p = 0.000) or acetylsalicylic acid (61% versus 11%; p = 0.000) than neurologists. In the cases, neurosurgeons and neurologists were similar in their choice for surgery as initial treatment (24% and 31%; p = 0.12), however variation existed amongst physicians in specific cases. Neurosurgeons preferred craniotomy with haematoma evacuation (74%) above minimally-invasive techniques (5%). Age, Glasgow Coma Scale score and ICH location were important factors influencing decisions on treatment for neurosurgeons and neurologists. 69% of neurosurgeons and 80% of neurologists would randomise patients in a trial evaluating the effect of minimally-invasive surgery on functional outcome. Discussion Our results reflect the lack of evidence about the right treatment strategy in patients with sICH. Conclusion New high quality evidence is needed to guide treatment decisions for patients with ICH. The willingness to randomise patients into a clinical trial on minimally-invasive surgery, contributes to the feasibility of such studies in the future.

scholarly journals Minimally invasive surgery plus alteplase for intracerebral haemorrhage

The Lancet ◽  
2019 ◽  
Vol 393 (10175) ◽  
pp. 965-967 ◽  
Author(s):  
Rustam Al-Shahi Salman ◽  
Catharina J M Klijn ◽  
Magdy Selim
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intracerebral Haemorrhage

Performance Increase in Venous Drainage for Mini-Invasive Heart Surgery: Superiority of Self-Expanding Cannulas

2014 ◽  
Vol 9 (4) ◽  
pp. 297-301 ◽  
Author(s):  
Mhedi Belkoniene ◽  
Saad Abdel-Sayed ◽  
Julien Favre ◽  
Ludwig-Karl Von Segesser
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Centrifugal Pump ◽  
Invasive Surgery ◽  
Heart Surgery ◽  
Small Diameter ◽  
Venous Drainage ◽  
Superior Performance ◽  
Set Up ◽  
Q Values

Objective Originally, the Smartcanula principle (collapsed insertion and expansion in situ) was developed for venous drainage by gravity. However, in minimally invasive surgery, augmentation with either constrained force vortex pumps or vacuum is often used. The current study was set up to assess whether smaller diameters of self-expanding venous cannulas are sufficient in conjunction with venous drainage augmentation resulting in smaller access orifices. Methods To evaluate cannulas intended for cardiopulmonary bypass, an in vitro circuit was set up with silicone tubing between the test cannula encased in a lower reservoir, the centrifugal pump, and after an upper reservoir. Afterload was set arbitrarily at 60 mm Hg using a centrifugal pump. The pressure value was measured using Millar pressure transducers. Flow rate (Q) was measured using an ultrasonic flow meter calibrated with volume tank and timer. Revolutions per minute of the centrifugal pump were calibrated with a stroboscope. Data display and data recording were controlled using a Lab View application. Self-expanding (24F Smartcanula) and control (25F Biomedicus) cannulas were used. Results Sixty measurements were recorded. At pump speed of 1500, 1570, 2000, 2500, and 3000 rpm, the Q values were 3.6, 5.2, 6.6, 9.3, and 11.8 L/min for the 24F self-expanding cannula and 3, 4.3, 5.4, 7.5, and 9.3 L/min for the control cannula. The pressure values were 3.6, −5.4, −15.9, −45.3, and 80.6 mm Hg. Biomedicus 25F showed Q values from 16% to 19% less as compared with 24F Smartcanula. The pressure values were 6, 7, 4, 2, and 2 times more as compared with 24F Smartcanula. Conclusions Our experimental evaluation demonstrated the superior performance of the Smartcanula with its self-expanding design in comparison with the reference commercially available standard cannulas. The Smartcanula with its small diameter is particularly welcome for minimally invasive surgery.

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