Neurosurgery, Jackson Memorial Hospital, University of Miami, Florida, USA.
Oper Neurosurg (Hagerstown). 2023 Oct 1;25(4):311-314. doi: 10.1227/ons.0000000000000804. Epub 2023 Aug 4.
Bedside procedures are often helpful for neurosurgical patients, especially in neurocritical care. Portable drills with technological advancements may bring more safety and efficiency to the bedside. In this study, we compared the safety and efficiency of a new cordless electric drill with smart autostop ("HD"-Hubly Cranial Drill, Hubly Surgical) with those of a well-established standard traditional electrical neurosurgical perforator ("ST").
A cadaveric study was conducted using both drills to perform several burr holes in the fronto-temporo-parietal region of the skull. An evaluation was performed on the number of dura plunges, and complete burr hole success rates were compared.
A total of 174 craniotomies using the HD and 36 burr holes using the ST perforator were performed. Despite significantly exceeding intended drill bit tolerance by multiple uses of a single-use disposable HD, autostop engaged in 100% of the 174 craniotomies and before violating dura in 99.4% of the 174 craniotomies, with the single dura penetration occurring on craniotomy no. 128 after the single-use drill bit had significantly dulled beyond its single-use tolerance. Autostop engaged before dura penetration for 100% of the 36 burr holes drilled with the ST perforator ( P = .610). All the perforations were complete using the HD after resuming drilling. An autostop mechanism in a cranial drill is not commonly available for portable bedside perforators. In the operating room, most use a mechanical method to stop the rotation after losing bone resistance. This new drill uses an electrical mechanism (smart autostop) to stop drilling, making it a single-use cranial drill with advanced features for safety and efficiency at the bedside.
There was no difference in the safety and efficacy of the new cordless electric drill with smart autostop when performing craniotomies compared with a traditional well-established electric cranial perforator with mechanical autostop on a cadaveric model.
床边操作对神经外科患者，尤其是神经重症患者，往往很有帮助。具有技术进步的便携式电钻可能会为床边操作带来更多的安全性和效率。在这项研究中，我们比较了一种新型无绳电钻（“HD”-Hubly 颅钻，Hubly 外科）与一种成熟的标准传统电神经外科穿孔器（“ST”）在安全性和效率方面的差异。
使用两种钻头在颅骨额颞顶区域进行了多次颅骨钻孔的尸体研究。评估了硬膜下钻的数量，并比较了完全钻孔成功率。
共进行了 174 例使用 HD 进行的开颅手术和 36 例使用 ST 穿孔器进行的颅骨钻孔。尽管在多次使用一次性 HD 钻头时明显超过了钻头的预期耐受能力，但在 174 例开颅术中，自动停止功能在 99.4%的情况下在钻穿硬膜之前介入，其中第 128 例开颅术在单次使用钻头明显超出其单次使用耐受能力变钝后发生单次硬膜穿透。在使用 ST 穿孔器进行的 36 个颅骨钻孔中，自动停止功能在 100%的情况下在钻穿硬膜之前介入（P =.610）。使用 HD 完成所有穿孔后，重新开始钻孔时，穿孔均完全。床边便携式穿孔器通常没有颅钻的自动停止功能。在手术室中，大多数情况下在失去骨阻力后使用机械方法停止旋转。这种新型电钻使用电气机制（智能自动停止）停止钻孔，使其成为一种具有先进安全和效率功能的一次性颅钻。
在尸体模型上，新型无绳电钻（具有智能自动停止功能）与具有机械自动停止功能的成熟标准电颅穿孔器在进行开颅术时的安全性和有效性方面没有差异。
