Hernesniemi Juha, Niemelä Mika, Karatas Ayse, Kivipelto Leena, Ishii Keisuke, Rinne Jaakko, Ronkainen Antti, Koivisto Timo, Kivisaari Riku, Shen Hu, Lehecka Martin, Frösen Juhana, Piippo Anna, Jääskeläinen Juha E
Department of Neurosurgery, Helsinki University Hospital, 00260 Helsinki, Finland.
Surg Neurol. 2005 Sep;64(3):195-200. doi: 10.1016/j.surneu.2005.04.031.
Microneurosurgical techniques introduced by Prof Yasargil in the 1960s have increased the neurosurgeon's ability to operate in small and often very narrow and deep gaps. Microneurosurgical techniques-ensuring an almost bloodless field and mostly obviating need for transfusion-should be atraumatic and noninvasive to the already lesioned central nervous system tissues and structures. Instruments in microneurosurgery range from very short to very long and from sturdy to delicate, depending on the working depth, characteristics of tissues, and the microneurosurgical anatomy. However, to keep it simple and fast, and to appreciate normal anatomy, it is preferable to use only a limited array of instruments. Besides the use of instruments and the operating microscope, everything else in the neurosurgical arena should be optimized and professional, such as the positioning of the patient and the conduct of neuroanesthesia. This review of the very basics is distilled from the Helsinki and Kuopio neurosurgery practices in Finland and from the senior author's (JH) experience of close to 10,000 operations, and this is to encourage young neurosurgeons of the world-most of them working with limited resources-to continue to improve their microneurosurgical skills to serve their patients best.
20世纪60年代由亚萨吉尔教授引入的显微神经外科技术，提高了神经外科医生在狭小且通常非常狭窄和深部间隙进行手术的能力。显微神经外科技术应确保几乎无血的手术视野，且大多无需输血，对已经受损的中枢神经系统组织和结构应无创且无创伤性。显微神经外科手术器械的长度从非常短到非常长，质地从坚固到精细，这取决于手术深度、组织特征和显微神经外科解剖结构。然而，为了保持操作简单快捷，并了解正常解剖结构，最好只使用有限的一系列器械。除了使用器械和手术显微镜外，神经外科领域的其他一切都应优化且专业，例如患者的体位摆放和神经麻醉的实施。这篇关于基础知识的综述是从芬兰赫尔辛基和库奥皮奥的神经外科实践以及资深作者（JH）近10000例手术的经验中提炼而来的，旨在鼓励全世界的年轻神经外科医生——他们中的大多数人资源有限——继续提高他们的显微神经外科技术，以便为患者提供最佳服务。
