Intraoperative Localization Using an Implanted Radar Reflector Facilitates Resection of Non-Palpable Trunk and Extremity Sarcoma

2020 ◽  
Author(s):  
Kristy Kummerow Broman ◽  
David Joyce ◽  
Odion Binitie ◽  
G. Douglas Letson ◽  
Ricardo J. Gonzalez ◽  
...  
Keyword(s):  
Extremity Sarcoma ◽  
Intraoperative Localization

Intraoperative localization of spatially and spectrally distinct resting-state networks in Parkinson’s disease

2020 ◽  
Vol 132 (4) ◽  
pp. 1234-1242 ◽  
Author(s):  
Paolo Belardinelli ◽  
Ramin Azodi-Avval ◽  
Erick Ortiz ◽  
Georgios Naros ◽  
Florian Grimm ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Network Effects ◽  
Brain Activity ◽  
Dynamic Imaging ◽  
Oscillatory Activity ◽  
Network Information ◽  
Novel Approach ◽  
Electrophysiological Recordings ◽  
Intraoperative Localization

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for symptomatic Parkinson’s disease (PD); the clinical benefit may not only mirror modulation of local STN activity but also reflect consecutive network effects on cortical oscillatory activity. Moreover, STN-DBS selectively suppresses spatially and spectrally distinct patterns of synchronous oscillatory activity within cortical-subcortical loops. These STN-cortical circuits have been described in PD patients using magnetoencephalography after surgery. This network information, however, is currently not available during surgery to inform the implantation strategy.The authors recorded spontaneous brain activity in 3 awake patients with PD (mean age 67 ± 14 years; mean disease duration 13 ± 7 years) during implantation of DBS electrodes into the STN after overnight withdrawal of dopaminergic medication. Intraoperative propofol was discontinued at least 30 minutes prior to the electrophysiological recordings. The authors used a novel approach for performing simultaneous recordings of STN local field potentials (LFPs) and multichannel electroencephalography (EEG) at rest. Coherent oscillations between LFP and EEG sensors were computed, and subsequent dynamic imaging of coherent sources was performed.The authors identified coherent activity in the upper beta range (21–35 Hz) between the STN and the ipsilateral mesial (pre)motor area. Coherence in the theta range (4–6 Hz) was detected in the ipsilateral prefrontal area.These findings demonstrate the feasibility of detecting frequency-specific and spatially distinct synchronization between the STN and cortex during DBS surgery. Mapping the STN with this technique may disentangle different functional loops relevant for refined targeting during DBS implantation.

Vascular reconstruction after retroperitoneal and lower extremity sarcoma resection

2017 ◽  
Vol 43 (2) ◽  
pp. 407-415 ◽  
Author(s):  
M. Wortmann ◽  
I. Alldinger ◽  
D. Böckler ◽  
A. Ulrich ◽  
A. Hyhlik-Dürr
Keyword(s):  
Lower Extremity ◽  
Vascular Reconstruction ◽  
Extremity Sarcoma

Intravenous methylene blue as an aid to intraoperative localization and removal of the adrenal glands during laparoscopic adrenalectomy

2003 ◽  
Vol 186 (5) ◽  
pp. 531-534 ◽  
Author(s):  
Robert J Obermeyer ◽  
Eric M Knauer ◽  
Michael P Millie ◽  
Herminio Ojeda ◽  
Michael B Peters ◽  
...  
Keyword(s):  
Methylene Blue ◽  
Laparoscopic Adrenalectomy ◽  
Adrenal Glands ◽  
Intraoperative Localization

Intraoperative localization of small intestinal bleeding in an infant by methylene blue injection: A case report

1998 ◽  
Vol 33 (5) ◽  
pp. 754-755 ◽  
Author(s):  
Mark V Mazziotti ◽  
Sean Muldowney ◽  
Michael Darcy ◽  
Brian P Hackett ◽  
Michael A Skinner
Keyword(s):  
Methylene Blue ◽  
Case Report ◽  
Intestinal Bleeding ◽  
Small Intestinal Bleeding ◽  
Small Intestinal ◽  
Intraoperative Localization

Optimization of Parallel-Hole Collimators for Intraoperative Localization of Iodine-125 Seeds

2016 ◽  
Vol 63 (5) ◽  
pp. 2527-2532 ◽  
Author(s):  
Bruno Arsenali ◽  
Kenneth G. A. Gilhuijs ◽  
Max A. Viergever ◽  
Hugo W. A. M. de Jong
Keyword(s):  
Iodine 125 ◽  
Intraoperative Localization ◽  
Parallel Hole

scholarly journals Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer

2013 ◽  
Vol 5 (2) ◽  
pp. 45-49
Author(s):  
Ian C Bennett ◽  
Magdalena Biggar ◽  
Clement Wong ◽  
Michael Law
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Lymph Nodes ◽  
Differentiated Thyroid Cancer ◽  
Intraoperative Ultrasound ◽  
Surgical Excision ◽  
Ultrasound Guided ◽  
Cervical Lymph Nodes ◽  
Intraoperative Localization

ABSTRACT As a result of sensitive thyroglobulin assays and widespread use of cervical ultrasound, endocrine surgeons are encountering patients with impalpable suspicious or frankly metastatic cervical lymph nodes in the follow-up phase after treatment for welldifferentiated thyroid cancer. The surgical excision of impalpable disease of recurrent or persistent thyroid cancer can represent a significant challenge which may require some means of intraoperative localization to ensure that affected nodes are removed. Surgeon-performed intraoperative ultrasound (IOUS) can be used for guiding excision of suspicious but impalpable cervical nodes. The IOUS-guided excision technique is described. The successful application of IOUS to localize and guide resection of impalpable nodal recurrences of papillary thyroid carcinoma in two patients is reported. The utilization of IOUS to guide resection of impalpable pathological nodes in the context of thyroid carcinoma is a safe and practical technique which avoids the need for additional localization procedures and unnecessary potential morbidity for the patient. How to cite this article Biggar M, Wong C, Law M, Bennett IC. Intraoperative Ultrasound-guided Excision of Cervical Lymph Nodes for Recurrent Differentiated Thyroid Cancer. World J Endoc Surg 2013;5(2):45-49.

scholarly journals Objective assessment of utility of intraoperative ultrasound in resection of central nervous system tumors: A cost-eff ective tool for intraoperative navigation in neurosurgery

2011 ◽  
Vol 02 (01) ◽  
pp. 004-011 ◽  
Author(s):  
Aliasgar Moiyadi ◽  
Prakash Shetty
Keyword(s):  
Spinal Cord ◽  
Objective Assessment ◽  
Tumor Resection ◽  
Intraoperative Ultrasound ◽  
Frameless Stereotaxy ◽  
Spinal Cord Tumors ◽  
Individual Parameter ◽  
Objective Evidence ◽  
Intraoperative Localization ◽  
Brain And Spinal Cord

ABSTRACT Background: Localization and delineation of extent of lesions is critical for safe maximal resection of brain and spinal cord tumors. Frame-based and frameless stereotaxy and intraoperative MRI are costly and not freely available especially in economically constrained nations. Intraoperative ultrasound has been around for a while but has been relegated to the background. Lack of objective evidence for its usefulness and the perceived “user unfriendliness” of US are probably responsible for this. We recount our experience with this “forgotten” tool and propose an objective assessment score of its utility in an attempt to revive this practice. Materials and Methods: Seventy seven intraoperative ultrasound (IOUS) studies were carried out in patients with brain and spinal cord tumors. Seven parameters were identifi ed to measure the “utility” of the IOUS and a “utility score” was devised (minimum 0 and maximum 7). Individual parameter and overall scores were calculated for each case. Results: IOUS was found to be useful in many ways. The median overall score was 6 (mean score 5.65). There were no scores less than 4 with the majority demonstrating usefulness in 5 or more parameters (91%). The use of the IOUS signifi cantly infl uenced the performance of the surgery in these cases without signifi cantly prolonging surgery. Conclusions: The IOUS is a very useful tool in intraoperative localization and delineation of lesions and planning various stages of tumor resection. It is easy, convenient, reliable, widely available, and above all a cost-eff ective tool. It should be increasingly used by neurosurgeons in the developing world where costlier intraoperative localization and imaging is not available freely.

Preoperative Localization of Spinal and Peripheral Pathologies for Surgery by Computed Tomography–Guided Placement of a Specialized Needle System

Neurosurgery ◽  
2010 ◽  
Vol 66 (4) ◽  
pp. 784-787 ◽  
Author(s):  
Philipp Slotty ◽  
Patrick Kröpil ◽  
Mark Klingenhöfer ◽  
Hans-Jakob Steiger ◽  
Daniel Hänggi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Peripheral Nerve ◽  
Radiation Exposure ◽  
Operating Room ◽  
Operating Room Personnel ◽  
Peripheral Nerve Surgery ◽  
Preoperative Marking ◽  
Intraoperative Fluoroscopy ◽  
Nerve Surgery ◽  
Intraoperative Localization

Abstract OBJECTIVE Exact intraoperative localization of pathologies in spinal and peripheral nerve surgery is not easily achieved. In spinal surgery, intraoperative fluoroscopy is the common method for identification of the level affected. It seldom visualizes the pathology itself and is prone to error in identifying anatomic disorders and superimposing structures. In peripheral nerve surgery, intraoperative fluoroscopy is of little value. The present technical study was conducted to evaluate the feasibility of using a preoperative computed tomography–guided needle marking system, which was previously developed for use in gynecology. The goal was to reduce intraoperative localization error and radiation exposure to patients and operating room personnel. METHODS We used a flexible hooked-wire needle marking system, which has previously been used for preoperative marking of breast lesions, to localize and tag spinal and peripheral nerve pathologies. Marking was carried out under computed tomographic control before surgery. Seven illustrative cases were chosen for this report: 6 patients with disorders of the spine and 1 patient with a peripheral nerve schwannoma. RESULTS No adverse reactions, aside from minor discomfort, were observed in this study. In all cases, the needle could be used as a reliable guide for the surgical approach and led directly to the pathology. In no case was additional intraoperative fluoroscopy needed. The level of radiation exposure to the patient as a result of computed tomography–based marking was similar to or less than that encountered in conventional intraoperative x-ray localization. Radiation exposure to the operating room personnel was eliminated by this method. CONCLUSION Preoperative marking of spinal level or peripheral nerve pathologies with a flexible hooked-wire needle marking system is feasible and appears to be safe and useful for neurosurgical spinal and peripheral procedures.

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