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Neurovascular Structures (neurovascular + structure)

Distribution by Scientific Domains

Medical Sciences	75%

Selected Abstracts

Appling the abdominal aortic-balloon occluding combine with blood pressure sensor of dorsal artery of foot to control bleeding during the pelvic and sacrum tumors surgery

JOURNAL OF SURGICAL ONCOLOGY, Issue 7 2008
Liu Yang MD
Abstract Background and Objectives To investigate the feasibilities of reducing intraoperative hemorrhage and improving the safety of pelvic and sacrum tumor surgery using sizing balloon occluding abdominal aorta. Method From May 2001 to May 2007, 18 patients were diagnosed as sacrum or pelvic tumor and underwent surgery in our institution. Balloon catheters were placed via femoral artery to occlude the abdominal aorta of pelvic tumor and sacrum region undergoing the sacrum resection or half pelvis resection and replacement operation in 12 patients. A sizing balloon was used to occlude the abdominal aorta for 60 min in assisting with resection of pelvic and sacral tumors. Results After the abdominal aorta was occluded, much less intraoperative hemorrhage was found, and the average blood loss was only 280 ml (range 200,600 ml). This procedure assisted the surgeon in identifying clearly the surgical margin and neurovascular structure surrounded by the tumors. The blood pressure remained stable during the operation. And the function of the kidney, the pelvis organs and the lower extremities were normal. Conclusion Intraoperative abdominal aorta occluding may effectively control intraoperative hemorrhage, thus assisting the surgeon in the complete and safe resection of pelvic and sacrum tumors. J. Surg. Oncol. 2008;97:626,628. © 2008 Wiley-Liss, Inc. [source]

Computer-aided navigation for arthroscopic hip surgery using encoder linkages for position tracking,

THE INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY, Issue 3 2006
Emily Monahan
Abstract Background While arthroscopic surgery has many advantages over traditional surgery, this minimally invasive technique is not often applied to the hip joint. Two main reasons for this are the complexity of navigating within the joint and the difficulty of correctly placing portal incisions without damaging critical neurovascular structures. This paper proposes a computer-aided navigation system to address the challenges of arthroscopic hip surgery. Methods Unlike conventional arthroscopic methods, our system uses a hyper-redundant encoder linkage to track surgical instruments, thus eliminating the occlusion and distortion problems associated with standard optical and electromagnetic tracking systems. The encoder linkage position information is used to generate a computer display of patient anatomy. Results The tracking error from the encoder linkage was evaluated to be within an acceptable range for this tracking prototype, and the new computer-aided approach to arthroscopic hip surgery was applied to a prototype system for concept verification. Conclusion This navigation system for arthroscopic hip surgery can be used as a tool to address the challenges of joint navigation and portal placement in arthroscopic hip surgery by visually supplementing the limiting view from the arthroscope. The introduction of a tracking linkage shows significant potential as an alternative to other tracking systems. Positive feedback about the completed demo system was obtained from surgeons who perform arthroscopic proceduces. Copyright © 2006 John Wiley & Sons, Ltd. [source]

Endoscopic Transnasal Craniotomy and the Resection of Craniopharyngioma,

THE LARYNGOSCOPE, Issue 7 2008
Aldo C. Stamm MD
Abstract Objectives/Hypothesis: To describe the utility of a large transnasal craniotomy and its reconstruction in the surgical management of patients with craniopharyngioma. Study Design: Observational retrospective cohort study. Methods: Retrospective review of patients treated in an academic neurosurgery/rhinology practice between 2000 and 2007. Patient characteristics (age, sex, follow-up), tumor factors (size, position extension, previous surgery), type of repair (pedicled mucosal flaps, free mucosal grafts), and outcomes (visual, endocrine, and surgical morbidity) were defined and sought in patients who had an entirely endoscopic resection of extensive craniopharyngioma (defined as requiring removal of the planum sphenoidale in addition to sella exposure in the approach). Results: Seven patients had an entirely endoscopic resection of extensive craniopharyngioma during the study period. Mean age was 23.4 years (standard deviation ± 16.3). Mean tumor size was 3.2 cm (standard deviation ± 2.0). The majority of these pathologies had extensive suprasellar disease, and two (28.6%) had ventricular disease. Cerebrospinal fluid leak rate was 29% (2 of 7). These leaks occurred only in reconstructions with free mucosal grafts. There were no cerebrospinal fluid leaks in patients who had vascularized pedicled septal flap repairs. Conclusions: The endoscopic management of large craniopharyngioma emphasizes recent advancements in endoscopic skull base surgery. The ability to provide exposure through a large (4 cm+) transnasal craniotomy, near-field assessment of neurovascular structures, and the successful reconstruction of a large skull defect have significantly advanced the field in the past decade. The use of a two-surgeon approach and bilateral pedicled septal mucosal flaps have greatly enhanced the reliability of this approach. [source]

The "safe zone" in medial percutaneous calcaneal pin placement

CLINICAL ANATOMY, Issue 4 2009
Zakareya Gamie
Abstract Percutaneous pin insertion into the medial calcaneus places a number of structures at risk. Evidence suggests that the greatest risk is to the medial calcaneal nerve (MCN). The medial calcaneal region of 24 cadavers was dissected to determine the major structures at risk. By using four palpable anatomical landmarks, the inferior tip of the medial malleolus (point A), the posterior superior portion of the calcaneal tuberosity (point B), the navicular tuberosity (point C), and the medial process of the calcaneal tuberosity (point D), we attempted to define the safe zone taking into account all possible variables in our dissections including ankle position, side, gender, and possible anatomical variations of the MCN. The commonest arrangement of the MCN was two MCNs that arose independently, one arising before the bifurcation of the tibial nerve and the other arising from the medial plantar nerve. A zone could be defined posterior to 75% of the distance along the lines AB, CD, AD, and CB which would avoid most structures. The posterior branches of the MCN, however, would still be at risk and placing the pin too far posteriorly risks an avulsion fracture. This is the first study to employ four palpable anatomical landmarks to identify a zone to minimize damage to neurovascular structures. It may not be possible, however, to avoid injury of the MCN and consequent sensory loss to the sole of the foot. foot. Clin. Anat. 22:523,529, 2009. © 2009 Wiley-Liss, Inc. [source]