Archivos de la categoría Instrumental

Bipolar Forceps

Aesculap

https://www.aesculapusa.com/products/neurosurgery/bipolar-forceps Range from the classic Yasargil style, with increased tension for tissue preparation, to Rose Gold Forceps Aesculap offers a wide variety of Rose Gold Tip Forceps including:

Scoville, Cushing, Hardy, Adson and Malis Designs, Straight and Bayonet Styles, Jewlers and Semkin Design, Microform Handle Designs, Reverse Action Designs, and Minimally Invasive (MIS) Designs, offering the latest technology in the reduction of tissue adhesion.

Bipolar Forceps are available in irrigating and non-irrigating, stainless steel or titanium, straight or bayoneted, insulated or non-insulated, and reusable or disposable.

BOWA-electronic

Covidien

DePuy Synthes

Spetzler-Malis Disposable Bipolar Forceps

Kirwan

Surgical’s Liberty AURA Elite Non-Stick Disposable Bipolar Forceps

Stainless

Titanium… http://www.ksp.com/our-products/reusable-bipolar-forceps.aspx

Scanlan

Sutter

Stryker

SilverGlide bipolar forcep technology is proprietary. It reduces the molecular bonding force and helps eliminate hot spots on the forcep tips. The level of thermal diffusivity of the silver alloy is significantly higher than that of stainless steel commonly used in standard forceps.

Storz*

Codman*

V. Mueller*

Mentor*

ASSI*

SSI*

Olsen*

MSI Precision*

Katena*

Ambler*

Titan Surgical*

Scanlon*

Jarit*

Integra*

Ruggles*

Redmond*

Elmed*

Medtronic*

Hummingbird Neuromonitoring

Hummingbird Neuromonitoring

http://www.hummingbirdneuromonitoring.com

Hummingbird Synergy is a novel single-port access device for multimodal intracranial monitoring that can be placed safely at the bedside or in the operating room with placement accuracy and has a complication profile similar to or better than that for standard external ventricular drains 1).

Hummingbird Neuromonitoring products help clinicians manage patients suffering from conditions that cause an elevated intracranial pressure.

Provides simultaneous ICP monitoring and CSF drainage, eliminates leveling of a fluid-based system, and enables re-zeroing in situ. This powerful mixture saves nursing time and provides optimized care for the patient.

In addition to developing the first monitoring technology that eliminates capital, they have also delivered the first integrated access device for multimodal monitoring, Hummingbird Synergy. Providing precision access, Hummingbird Synergy combines access for brain probes, ventricular drainage, and parenchymal ICP through a single twist-drill hole. Together, the Hummingbird ICP and Hummingbird Synergy are a powerful combination that reduces procedural complications and optimizes patient care.

The products, which include multimodal, traditional bolt based, and tunneled catheter systems, have been used in thousands of procedures in centers across the United States. With a commitment to continuous innovation, Hummingbird addresses unmet clinical needs and is poised to become the new standard of care for treating patients suffering from traumatic brain injury and stroke.

Multimodal Monitoring Systems

Traditional Bolt Based Systems

Tunneled Ventricular System

Products

Hummingbird Synergy Ventricular

Hummingbird SynergyDuo Ventricular

Hummingbird Synergy Parenchyma

Hummingbird SynergyDuo Parenchyma

Hummingbird Synergy Parenchyma with Temperature

Hummingbird Temperature Probes

1) Chohan MO, Akbik OS, Ramos-Canseco J, Ramirez PM, Murray-Krezan C, Berlin T, Olin K, Taylor CL, Yonas H. A novel single twist-drill access device for multimodal intracranial monitoring: a 5-year single-institution experience. Neurosurgery. 2014 Sep;10 Suppl 3:400-11. doi: 10.1227/NEU.0000000000000451. PubMed PMID: 24887290.

Lumbar discectomy haptic simulator

A cognitive task analysis (CTA) was performed to define a realistic and helpful scenario-based simulation. Based on the results a simulator for lumbar discectomy was developed. Additionally, a realistic training operating room was built by Adermann et al.,.

The CTA showed a need for realistic scenario-based training in spine surgery. The developed simulator consists of synthetic bone structures, synthetic soft tissue and an advanced bleeding system. Due to the close interdisciplinary cooperation of surgeons between engineers and psychologists, the iterative multicentre validation showed that the simulator is visually and haptically realistic. The simulator offers integrated sensors for the evaluation of the traction being used and the compression during surgery. The participating surgeons in the pilot workshop rated the simulator and the training concept as very useful for the improvement of their surgical skills.

In the context of the present work a precise definition for the simulator and training concept was developed. The additional implementation of sensors allows the objective evaluation of the surgical training by the trainer. Compared to other training simulators and concepts, the high degree of objectivity strengthens the acceptance of the feedback. The measured data of the nerve root tension and the compression of the dura can be used for intraoperative control and a detailed postoperative evaluation1.

  1. Adermann J, Geißler N, Bernal LE, Kotzsch S, Korb W. Development and validation of an artificial wetlab training system for the lumbar discectomy. Eur Spine J. 2014 Sep;23(9):1978-83. doi: 10.1007/s00586-014-3257-3. Epub 2014 Mar 5. PubMed PMID: 24595488. []

4 examples of endoscopic transsphenoidal resection of a craniopharyngioma

These series of videos demonstrate 4 examples of endoscopic transsphenoidal resection of a craniopharyngioma. Figures and captions for relevant anatomy during tumor resection are depicted at the end of each video.Case 1 (0:06): The patient is a 54-year-old male that was found to have a 2.6 x 2.0 x 3.6 cm cystic sellar mass with suprasellar extension upon workup of headaches, fatigue, gynecomastia, and decreased libido. His laboratory studies demonstrated central hypogonadism and central hypothyroidism.Case 2 (2:28): The patient is a 29-year-old male that was found to have a 3.6 x 2.7 x 2.5 cm sellar mass with suprasellar extension upon workup of headaches, decreased libido, and visual field deficits. The mass has both a cystic and solid component. His pre-operative endocrine laboratory studies demonstrated adrenal insufficiency, hypogonadism, and hypothyroidism.Case 3 (4:39): The patient is a 61-year-old female that was found to have a 1.7 x 1.4 x 1.1 cm sellar mass with suprasellar extension upon workup of headaches, fatigue, vertigo, and blurry vision. The mass has both a cystic and solid component. Her pre-operative endocrine laboratory studies were unremarkable.Case 4 (5:58): The patient is a 32-year-old female that was found to have a 1.9 x 1.3 x 2.8 cm solid sellar mass with extension into the 3rd ventricle upon workup of headaches, horizontal diplopia, and bilateral abducens nerve palsies. Her pre-operative endocrine laboratory studies were unremarkable

Chu J, Oyesiku N. 3-D Endoscopic Transsphnoidal Pituitary Surgery: 4 Unique Cases of Craniopharyngioma. Neurosurgery. 2014 Aug 27. [Epub ahead of print] PubMed PMID: 25167380.

Ventriculostomy simulator

Hooten et al., developed a ventriculostomy simulator and its validation as a necessary training tool in neurosurgical residency.

They tested the simulator in over two hundred sixty residents. An algorithm combining time and accuracy was used to grade performance. Voluntary post performance surveys were used to evaluate the experience.

Results demonstrate that more experienced residents have statistically significant better scores and completed the procedure in less time than inexperienced residents. Survey results revealed that most residents agreed that practice on the simulator would help with future ventriculostomies.

This mixed reality simulator provides a real life experience, and will be an instrumental tool in training the next generation of neurosurgeons. They implemented a standard where incoming residents must prove efficiency and skill on the simulator prior to their first interaction with a patient1.

  1. Hooten KG, Lister JR, Lombard G, Lizdas DE, Lampotang S, Rajon DA, Bova F, Murad GJ. Mixed Reality Ventriculostomy Simulation: Experience in Neurosurgical Residency. Neurosurgery. 2014 Jul 18. [Epub ahead of print] PubMed PMID: 25050577. []

Is intracranial pressure monitoring still required in the management of severe traumatic brain injury? Ethical and methodological considerations on conducting clinical research in poor and low-income countries.

La industria-fabricantes de medicamentos, dispositivos y equipos médicos, y su poder político influyen en gran medida en las estrategias de investigación clínica.

Pueden intervenir, a través de expertos con lazos a la industria financiera mediante la divulgación o silencio, en la formación y difusión afectando así la práctica clínica diaria.

Los intereses de la industria no están necesariamente alineados con los intereses de los pacientes y de la sociedad pudiendo perjudicar y reducir la confianza en la investigación clínica.

Es obvio que el creciente número de ensayos clínicos llevados a cabo en los países en vias de desarrollo requiere el compromiso de todas las partes interesadas para garantizar la adhesión a un conjunto de principios éticos internacionalmente aceptados que reflejan una de las premisas éticas básicas de la Declaración de Helsinki; es decir, que los intereses de la ciencia y la sociedad no son una excusa para llevar a cabo ensayos clínicos en estos países.

La investigación clínica transnacional debería ser controlado por juntas de revisión ética acreditados internacionalmente, y los protocolos de investigación rechazados en un país no deberían ser permitidos en otro.

Además, los organismos internacionales de vigilancia en investigación humana deben tener “… la facultad de sancionar a las empresas y grupos de investigación que no respetan las normas universales ”.

Mientras se implementan estos mecanismos, el papel de las principales revistas que publican los resultados de los ensayos clínicos es crucial, ya que cuando aparecen en una revista de impacto, conducen a una especie de aprobación profesional, y el artículo se vuelve más atractivo tanto para el lector como los medios de comunicación, pudiendo distorsionar el valor real de los resultados.

Los procesos de revisión por pares tradicionales utilizados por los editores de revistas para ayudar a decidir qué artículos deben ser publicados no son capaces de filtrar algunas de las técnicas más sofisticadas de marketing y conflictos de intereses encubiertos.

La incorporación de especialistas en ética en este proceso de revisión probablemente ayude a levantar estos peligros y considerar adecuadamente que el estudio fue aceptado por un “comité de ética” de alguna universidad de prestigio.

Al rechazar los estudios éticos sospechosos, los editores ayudarán en la construcción de una comunidad científica más saludable y el envío de un mensaje claro, a científicos e industria, sore lo inaceptable de explotar y dañar de forma potencial a algunas personas por el bien de muchos 1).

1) Sahuquillo J, Biestro A. Is intracranial pressure monitoring still required in the management of severe traumatic brain injury? Ethical and methodological considerations on conducting clinical research in poor and low-income countries. Surg Neurol Int. 2014 Jun 5;5:86. doi: 10.4103/2152-7806.133993. eCollection 2014. PubMed PMID: 25024886; PubMed Central PMCID: PMC4093744.