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Since the introduction of electrosurgery the techniques of surgery on the nervous system have passed through further improvements (bipolar coagulation, microscope), even if the procedure was not substantially modified. Today, laser represents a new "discipline", as it offers a new way of performing all basic maneuvers (dissection, demolition, hemostasis, vessel sutures). Furthermore, laser offers the possibility of a special maneuver, namely reduction of the volume of a tumoral mass through vaporization. Its application is not restricted to traditional neurosurgery but extends also to stereotactic and vascular neurosurgery. Laser surgery has also influenced the anesthesiologic techniques. At the same time new instrumentation has been introduced: CUSA ultrasonic aspiration, echotomography, and Doppler flowmeter. I have had the chance to utilize these new technologies all at a time and have come to the conclusion that we are facing the dawn of a new methodology which has already shown its validity and lack of inconveniences, and whose object is to increase the precision of neurological surgery. The technological development is still going on, and some improvements are to be foreseen. Laser scalpel is splitting the initial laser surgery into NO TOUCH and TOUCH surgery with laser. As new instrumentarium will be developed, a variable and tunable beam will become available. For example, in a few years Free Electron Laser will further add to the progress in this field.
Intraoperative imaging technologies have taken an ever-increasing role in the daily practice of neurosurgeons and the increasing attention and interest necessitated international interaction and collaboration. The Intraoperative Imaging Society was formed in 2007. This book brings together highlights from the second meeting of the Intraoperative Imaging Society, which took place in Istanbul-Turkey from June 14 to 17, 2009. Included within the contents of the book is an overview of the emergence and development of the intraoperative imaging technology as well as a glimpse on where the technology is heading. This is followed by in detail coverage of intraoperative MRI technology and sections on intraoperative CT and ultrasonography. There are also sections on multimodality integration, intraoperative robotics and other intraoperative technologies. We believe that this book will provide an up-to date and comprehensive general overview of the current intraoperative imaging technology as well as detailed discussions on individual techniques and clinical results.
Over the last 18 years, there have been many advances in the field of intraoperative monitoring. This new edition of Neurophysiology in Neurosurgery: A Modern Approach provides updates on the original techniques, as well as other more recent methodologies that may either prove beneficial or are commonly used in neuromonitoring. The purpose of this book is to describe the integration of neuromonitoring with surgical procedures. Each methodology is discussed in detail as well as chapters describing how those methodologies are applied to multiple surgical procedures and the evidence used to support those uses. The second edition features a surgical procedure section, which focuses on specific surgical procedures and the type of monitoring used during these procedures. The original chapters have been updated, expanded, and the structure modified to ensure the book is beneficial to both physiologists and surgeons. This book is written for neurosurgeons, neurophysiologists, neurologists, anesthesiologists, interventional neuroradiologists, orthopedic surgeons, and plastic surgeons. - Provides a valuable educational tool that describes the theoretical and practical aspects of intraoperative monitoring through example - Presents in-depth descriptions of the most advanced techniques in intraoperative neurophysiological monitoring and mapping - Features a surgical procedures section that focuses on specific surgical procedures and the type of monitoring used during these procedures
This book is intended as a practical manual on the use of intraoperative ultrasound (IOUS) as a tool for imaging guidance during cranial and spinal neurosurgical procedures. Full account is taken of the emergence of novel clinical applications and recent technical advances, with extensive coverage of the impact of developments such as improved probe technology, fusion imaging and virtual navigation, 3D ultrasound imaging, contrast-enhanced ultrasound, and elastosonography. Basic principles of ultrasound are elucidated in order to assist in the optimal use of IOUS and clear guidance is provided on the interpretation of imaging findings in various pathologies. Informative comparisons are also made of the use of techniques such as fusion imaging and contrast-enhanced ultrasound in general radiology and neurosurgery. The aim of the authors is to enhance the general knowledge regarding intra-operative ultrasound brain imaging, standardizing its use and exploring new techniques, leading in some way toward compensating the lack of specific training in the application of ultrasound among the neurosurgical community. IOUS is a sensitive tool that can improve surgical precision and help to reduce morbidity.
Designed to inform practitioners about the utility and application of ultrasonography in neurosurgical operations. General subjects covered include: physics and techniques, the use of ultrasound imaging during intracranial operations, ultra-sonography in spinal cord surgery and intraoperative sonography of the Arnold-Chiari malformations. Annotation copyrighted by Book News, Inc., Portland, OR
The definitive reference on intraoperative MR-guided neurosurgery Comprehensive in scope and packed with practical information, Intraoperative MR-Guided Neurosurgery contains detailed coverage of this state-of-the-art technology from the pioneers who developed it. Renowned neurosurgeons and neuroradiologists combine their collective wisdom and experience to demonstrate how MR-guided neuronavigation can be used to view real-time images of a patient's brain during surgery to help remove tumors with greater precision. The authors provide step-by-step descriptions of how to perform procedures, including advice based on their clinical results. Readers will learn about the advantages and drawbacks of the various MR imaging systems, clinical indications for MR-guidance, anesthesia considerations, safety concerns related to working in a magnetic environment, and much more. Features: In-depth coverage of all MR imaging systems helps readers to make informed choices about which technique will best suit their surgical needs Guidelines on the most appropriate imaging sequences for the resection of different types of brain tumors More than 200 high-quality intraoperative photographs taken during actual procedures to orient readers who want to use MRI in the operating room Tips from the experts on safety issues, suitable magnet designs and field strengths, cost and benefit analysis, room design, equipment, and logistics Discussion of other forms of technology that have been combined with intraoperative MR-guidance, such as focused ultrasound, neurosurgical robotics, and other promising innovations This leading-edge text has everything that neurosurgeons, neuroradiologists, and interventionalists need to know to implement an intraoperative MR-guided neurosurgery program.
Richly illustrated to showcase the best practices, surgical methods, and procedures for difficult situations in neurosurgery, this reference demonstrates strategies to manage brain metastases, intracranial gliomas and meningiomas, pituitary region tumors, and intracranial vascular malformations; spinal operations; and surgeries of the skull base with modern navigation and image-guidance technologies.
Image-Guided Neurosurgery provides readers with an update on the revolutionary improvements in imaging and visualization relating to neurosurgery. From the development of the pneumoencephalogram, to the operating microscope, to cross sectional imaging with CT and later MRI, to stereotaxy and neuronavigation, the ability to visualize the pathology and surrounding neural structures has been the driving factor leading surgical innovation and improved outcomes. The book provides a comprehensive reference on the application of contemporary imaging technologies used in neurosurgery. Specific techniques discussed include brain biopsies, brain tumor resection, deep brain stimulation, and more. The book is ideal for neurosurgeons, interventional radiologists, neurologists, psychiatrists, and radiologists, as well as technical experts in imaging, image analysis, computer science, and biomedical engineering. - A comprehensive reference on image-guided neurosurgery - Includes coverage of neuronavigation in cranial surgery and advanced imaging, including functional imaging, adoption of intra-operative MRI and emerging technologies - Covers all image-guided neurosurgery tools, including robotic surgical devices - Ideal reference for topics relating to neurosurgery, imaging, stereotaxis, radiosurgery, radiology, epilepsy, MRI, the use of medical robotics, lasers, and more
Through real-time assessments of how the patient's nervous system is functioning throughout a surgical procedure, Neurophysiology in Neurosurgery presents vital techniques to guide surgeons in their efforts to minimize the risks of unintentional damage to healthy nervous tissue. This book provides a comprehensive overview of the most up-to-date intraoperative neurophysiological techniques and guidelines for the managment of neuroanesthesia during MEP monitoring. Neurophysiology in Neurosurgery is a valuable educational tool that describes the theoretical and practical aspects of intraoperative monitoring through example. Neurophysiology in Neurosurgery is a valuable educational tool that describes the theoretical and practical aspects of intraoperative monitoring through example. The authors provide in-depth descriptions of the most advanced techniques in intraoperative neurophysiological monitoring and guidelines for the management of neuroanesthesia during MEP monitoring.
This book covers stereotactic principles as well as functional stereotaxis, covering the history and uses of the techniques, treatments for specific conditions, and future developments. Includes a DVD demonstrating surgical procedures.