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 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

Speculation on the Neuropsychology of Teleoperation: Implications for Presence Research and Minimally Invasive Surgery

2008 ◽  
Vol 17 (2) ◽  
pp. 199-211 ◽  
Author(s):  
Andrew N. Healey
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Interface Design ◽  
New Technology ◽  
Human Action ◽  
Task Demands ◽  
Neural Basis ◽  
Invasive Techniques ◽  
Brain Processing

Teleoperation is now common in high-risk work domains, particularly in surgery with the extensive use of remote, minimally invasive techniques. While this new technology affords a novel means by which to control human action for surgical intervention, interface design often constrains the operator in unorthodox ways, requiring considerable adaptation and raising patient safety concerns. There is a need to objectively measure operator adaptation, evaluate varying teleoperator interface designs and assess the efficacy of the virtual reality trainers that simulate teleoperation. This paper highlights the potential for a neuroergonomic approach to these problems. It first delineates some of the task demands unique to teleoperation in minimally invasive surgery and then speculates on the neural basis of those tasks with reference to select neuropsychological literature. The integration of this literature serves to indicate that teleoperation may engage a unique pattern of brain processing and that neuropsychological measurement may therefore be useful in evaluating the design of the teleoperation interface and teleoperator adaptation.

scholarly journals Minimally Invasive Approaches in the Thoracic Surgery

2021 ◽  
Author(s):  
Güntuğ Batıhan ◽  
Kenan Can Ceylan
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Thoracic Surgery ◽  
Invasive Surgery ◽  
Minimally Invasive Techniques ◽  
The Past ◽  
Minimally Invasive Surgical ◽  
First Choice ◽  
Surgical Methods ◽  
Invasive Techniques

Minimally invasive techniques in thoracic surgery have made great progress over the past 20 years and are still evolving. Many surgical procedures performed with large thoracotomy incisions in the past can now be performed with much smaller incisions. With many studies, the advantages of minimally invasive surgery have been clearly seen, and thus its use has become widespread worldwide. Today, minimally invasive surgical methods have become the first choice in the diagnosis and treatment of lung, pleural and mediastinal pathologies. Minimally invasive approaches in thoracic surgery include many different techniques and applications. In this chapter, current minimally invasive techniques in thoracic surgery are discussed and important points are emphasized in the light of the current literature.

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 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
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