Rate-controlled intraventricular endoscopic irrigation via bipolar foot pedal activation: technical note
Autor: | Reid Hoshide, Gayle Gyles, Carlos E Sanchez, Joel R. Martin, Robert C. Rennert, Michael J. Levy, Vincent J Cheung |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Irrigation Endoscope business.industry Tumor resection Normal intracranial pressure Technical note General Medicine Perioperative Surgery 03 medical and health sciences 0302 clinical medicine Neuroendoscopy 030220 oncology & carcinogenesis medicine business 030217 neurology & neurosurgery Foot (unit) |
Zdroj: | Journal of Neurosurgery: Pediatrics. 25:434-438 |
ISSN: | 1933-0715 1933-0707 |
DOI: | 10.3171/2019.11.peds19471 |
Popis: | Irrigation during intraventricular endoscopic surgery is critical for visualization, with normal intracranial pressure maintained by balancing fluid ingress and egress. Although irrigation is typically achieved through manual manipulation of inexact stopcocks, the authors have developed a rate-controlled, foot pedal–activated system for precise intraventricular irrigation by using a standard irrigating bipolar electrocautery machine.This study is a retrospective review of patients who underwent endoscopic intraventricular surgery between January 1, 2018, and September 25, 2019, in which this irrigation system was used. Important components of this system include a bipolar module irrigation regulator that is set to a desired rate, a secure connection of the bipolar irrigation tubing to the endoscope, and one or more open egress ports on the endoscope for passive fluid drainage. Nineteen consecutive patients were identified on review (average age ± SD, 4.3 ± 4.1 years). Procedures performed included third ventriculostomies (n = 10); arachnoid/choroid cyst fenestrations/resections (n = 3); biopsy/tumor resection (n = 1); and combined procedures (n = 5). Foot pedal–controlled irrigation provided visualization of all intraventricular structures. A single operator was able to control the endoscope, endoscopic instruments, and irrigation, with assistance as indicated for more complex maneuvers. There were no perioperative complications. Because this setup is easily constructed from a standard irrigating bipolar machine, delivers precise irrigation flow rates, and facilitates a single-surgeon bimanual technique, these data support the utility of foot-controlled irrigation for endoscopic intraventricular surgery. |
Databáze: | OpenAIRE |
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