engleski

The usage of new ultrasonic microprobe in neuroendoscopy

The role of endoscopic procedures in adult and pediatric neurosurgery is rapidly growing, not only for the treatment of different obstructive hydrocephalus forms, but also for the other indications: various intracranial cysts and intraventricular space occupying lesions. The usage of different neuroendosopic techniques and instruments (blunt perforation, endoscopic scissors and forceps, mono and bipolar electrocoagulation and laser) clearly demonstrates unsufficiency of the existing neuroendoscopic armamentarium. We report our experience with originally constructed Neurosurgical Endoscope Contact Ultrasound Probe “ NECUP-2” in neuroendoscopy. The newly developed “ NECUP-2” consists of the ultrasound generator (amplitude 300 μ m, intensity 900 W/cm2, acceleration 400000 m/s2, frequency 25000 Hz), and titanium microprobe with 1.6 mm diameter which easily passes through the 2.2 mm ventriculoscope working channel. The ultrasound intensity can be changed from low to high, enabling tissue perforation and removal with preserving of the vascular structures. Between June 1997 and June 2007, 132 neuroendoscopic procedures have been performed: 102 ETV, 10 septotomies, 15 arachnoid cysts and 5 intraventricular tumors. The “ NECUP-2” was applied effectively in all cases in which blunt perofration was not possible: 38/102 ETV, 10/10 septostomies, 15/15 arachnoid cysts. In the five cases of intraventricular tumors neuroendosopic procedure was combined with open microsurgery for tumor removal with preservation of vascular structures. There wasn't any “ NECUP-2” related complications. Our preliminary results demonstrate that the application of the “ NECUP-2” in neuroednosopic procedures is effective and safe, and can be a useful addition to standard neuroendoscopic instruments and techniques.

ultrasonic microprobe; neuroendoscopy; new; usage; NECUP-2

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