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经颅超声微吸引术治疗脑内病变:一种新的治疗方法(病例系列研究)

Novel Use of the Aurora Surgiscope System for Minimally Invasive Resection of Intraparenchymal Lesions: A Case Series.

机构信息

Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Department of Neurosurgery, Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

Oper Neurosurg (Hagerstown). 2022 Sep 1;23(3):182-187. doi: 10.1227/ons.0000000000000292. Epub 2022 Jun 14.

Abstract

BACKGROUND

Minimally invasive surgery (MIS) for intracranial pathology minimizes surgical morbidity but can come at the cost of operator ergonomics and technical surgical success. Here, the authors present a case series to report the first use of a novel 15-mm tubular retraction system with integrated lighting and visualization capabilities for MIS access to intracranial lesions.

OBJECTIVE

To demonstrate feasibility and effectiveness of the 15-mm Aurora Surgiscope (Integra Lifesciences) for intracranial MIS approaches.

METHODS

The 15-mm Aurora Surgiscope facilitated MIS approach to gain access to intraparenchymal pathologies. The device consists of a tubular access system with integrated light source and a reusable control unit that modifies video parameters. The port was inserted along a preplanned trajectory through a mini-craniotomy. Bimanual access allowed the surgeon to comfortably dissect/resect lesional tissue using high-quality video.

RESULTS

Four patients are presented. In cases 1 and 2, the authors evacuated acute intracerebral hemorrhages. Both had <15 cc hemorrhage with improved or stable neurological examination. In case 3, the authors performed gross total resection of a cerebellar pilocytic astrocytoma. In case 4, the authors resected a mesial posterior temporal cavernoma. No perioperative/technical complications were noted.

CONCLUSION

The Aurora Surgiscope system is a novel integrated tubular retraction, lighting, and visualization system that allows access to a wide variety of pathologies using a MIS approach. The Surgiscope allows the surgeon to use bimanual dexterity through a small access port while limiting the need for additional equipment such as microscope, exoscope, or endoscope.

摘要

背景

微创外科(MIS)治疗颅内病变可最大程度降低手术的发病率,但可能会影响手术者的舒适度和技术手术成功率。本文作者报告了首例使用新型 15mm 管状牵开系统进行微创入路治疗颅内病变的病例系列,该系统具有集成照明和可视化功能。

目的

演示 15mm Aurora Surgiscope(Integra Lifesciences)用于颅内 MIS 入路的可行性和有效性。

方法

15mm Aurora Surgiscope 辅助 MIS 入路以进入脑实质内病变。该设备由一个管状进入系统组成,集成了光源和一个可重复使用的控制单元,可调节视频参数。该端口通过迷你开颅术沿着预先规划的轨迹插入。双手操作允许外科医生使用高质量的视频舒适地解剖/切除病变组织。

结果

介绍了 4 例患者。在病例 1 和 2 中,作者清除了急性脑内血肿。出血量均<15cc,神经功能检查改善或稳定。在病例 3 中,作者行小脑毛细胞星形细胞瘤的大体全切除。在病例 4 中,作者切除了中颞后动静脉畸形。无围手术期/技术并发症。

结论

Aurora Surgiscope 系统是一种新型的集成管状牵开、照明和可视化系统,可通过微创入路治疗多种病变。Surgiscope 允许外科医生通过小的入路端口使用双手灵巧性,同时限制了对显微镜、手术放大镜或内窥镜等额外设备的需求。

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