engleski

The role of intraoperative ultrasound in minimal invasive neurosurgery

Introducing intraoperative US in our Department in 1992 one of its first usage was deep seated tumors localisation. This is still the most important role of this device. In that way we may choose the shortest approuch to the lesion performing minimal dural incision as well as minimal corticotomy and parenchimal demage. Rotating the transducer in all directions and axies we make three dimension lesion picture and its position to surrounding structures . We use B&K Medical device with changeable frequency from 5, 6.5 to 8 Mz for superficial and deep seated lesions procedures. Another usage is in US-guided neurosurgical procedures. These are intracranial lesions biopsies, cysts and abscesses punctures and evacuations, ventricular punctures for hydrocephalus shunt operations and US-guided microneurosurgical resections. Advantages of US-guided operations are shorteness of the procedure, simplicity ( no need for additional CT scanning), no irradiation and the most important- real time imaging.The disadvantages of the method are worse resolution of images in deep- seated and small lesions and need for small trepanation because of the tranducer tip dimension. We also use US in neuronavigation procedures in microneurosurgical operations. The procedure is very simple, no time consuming. After the lesion localisation we insert through the fixable guidance a thin silicon catheter just to the lesion. All procedure is in real time imaging under the visual control so we can intervene in the case of intraoperative complications. In our opinion these procedures are very usefull in neurosurgical work especially microneurosurgical operations

ultrasound; minimally invasive neurosurgery

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