engleski

The neurosurgical endoscopic contact ultrasonic probe: technological aspects

During interdisciplinary collaboration in scientific-research programmes in the field of high power ultrasound applications in neurosurgery, a possibility to apply high-power ultrasonic point sources for minimally invasive neurosurgery has been noticed. Earlier experiences with noncontact applications of high energy therapeutic ultrasound have induced the idea of ultrasonic energy transfer through an elastic wire waveguide. Development of a new type of neurosurgical endoscopic contact ultrasonic probe – knife, which started in 1999, has resulted in a fully functional prototype - NECUP 1. With that device, the controlled, direct and predictable point impact of the high-power ultrasound source to the neural tissue has been achieved. That new and effective tool in neurosurgical armamentarium widened high-power ultrasound application area in the endoscopic surgery for the procedure of the endoscopic third ventriculostomy, where the other techniques are used (monopolar/bipolar coagulators, contact laser etc.). The applicated minimally invasive procedure enables tissue fragmenting with defined lesion dimensions at minimal thermal and ultrastructural damage of the adjacent neural structures with maximal preservation of vascular structures. Further advances in interdisciplinary knowledge on contact applications of high-power ultrasound in general surgery, resulted in development of an improved contact ultrasonic surgical system – NECUP 2. The device consists from the ultrasonic generator, ultrasonic transducer and a foot switch. The ultrasonic transducer has been realized as a rod-type resonant vibrating system, con&not ; ; sisting of a half-wave length transducer of piezoceramic material, and a resonant wave guide in the form of a specially shaped velocity transformer with titanium wire. The newly designed NECUP 2 is 1, 6 mm in diameter and easily passes through the 2 mm ventriculoscope working channel. The principle of ultrasonic surgery (direct cutting, cavitation, fragmentation and thermal damage) enables simple removal of the desired tissue performed in the visual field of a ventriculoscope video camera. Acknowledgment: This work was sponsored by the Ministry of Science and Technology, SRP No. 01920203) and by the Croatian Program for Innovative Technological Development No. TP-01/0220-01.

ultrasound; neurosurgery; NECUP

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