Advanced Intraoperative Technologies in Neurosurgery

1. Front Matter

   Pages I-X

   PDF

2. Intraoperative Ultrasound

   1. Front Matter

      Pages 1-1

      PDF

   2. Intraoperative Real-Time Ultrasonography: Localization, Characterization and Instrumentation of Lesions of Brain and Spinal Cord

      • George J. Dohrmann, Jonathan M. Rubin

      Pages 3-19

   3. Intraoperative A-Mode Echoencephalography in Neurosurgery

      • Victor A. Fasano

      Pages 20-26

   4. Intraoperative Dopplersonography

      • Joachim M. Gilsbach, Albrecht Harders

      Pages 27-47

3. Laser Neurosurgery

   1. Front Matter

      Pages 49-49

      PDF

   2. Historical Introduction

      • Victor A. Fasano

      Pages 51-52

   3. Laser Physic

      • Victor A. Fasano

      Pages 53-71

   4. Laser Effect on Normal Nervous Tissue (CO2-Nd: YAG). Histological Data

      • Victor A. Fasano

      Pages 72-84

   5. Laser Effect on Normal Vessels (CO2-Nd: YAG-Argon). Histological Data

      • Victor A. Fasano

      Pages 85-92

   6. Laser. A Progress of the Traditional Surgical Procedure

      • Victor A. Fasano

      Pages 93-96

   7. Principles of Laser Surgery

      • Victor A. Fasano

      Pages 97-102

   8. Laser Safety

      • Victor A. Fasano

      Pages 103-106

   9. Laser Neurosurgical Techniques

      • Victor A. Fasano

      Pages 107-139

   10. Contact Laser

       • Victor A. Fasano

       Pages 140-144

   11. The Argon Laser and Its Application in Neurological Surgery

       • Michael S. B. Edwards, James E. Boggan

       Pages 145-153

   12. Laser in the Removal of Extraaxial Tumors of the Brain and Spinal Cord

       • Leonard J. Cerullo

       Pages 154-161

   13. The Stereotactic CO2 Laser: Instrumentation, Methodology and Clinical Results

       • Patrick J. Kelly

       Pages 162-174

   14. The Use of Lasers in Nerve Repair

       • Isabelle L. Richmond

       Pages 175-183

   15. Laser Vascular Application: Reconstructive and Reparative

       • Charles R. Neblett

       Pages 184-194

Since the introduction of electrosurgery the techniques of surgery on the nervous system have passed through further improvements (bipolar coagulation, microscope), even if the procedure was not substantially modified. Today, laser represents a new "discipline", as it offers a new way of performing all basic maneuvers (dissection, demolition, hemostasis, vessel sutures). Furthermore, laser offers the possibility of a special maneuver, namely reduction of the volume of a tumoral mass through vaporization. Its application is not restricted to traditional neurosurgery but extends also to stereotactic and vascular neurosurgery. Laser surgery has also influenced the anesthesiologic techniques. At the same time new instrumentation has been introduced: CUSA ultrasonic aspiration, echotomography, and Doppler flowmeter. I have had the chance to utilize these new technologies all at a time and have come to the conclusion that we are facing the dawn of a new methodology which has already shown its validity and lack of inconveniences, and whose object is to increase the precision of neurological surgery. The technological development is still going on, and some improvements are to be foreseen. Laser scalpel is splitting the initial laser surgery into NO­ TOUCH and TOUCH surgery with laser. As new instrumentarium will be developed, a variable and tunable beam will become available. For example, in a few years Free Electron Laser will further add to the progress in this field.

• neurosurgery
• surgery

• Institute of Neurosurgery, University of Turin, Italy

  Victor Aldo Fasano

• Department of Neurologic Surgery, Mayo Clinic, Mayo Medical School, Rochester, USA

  R. E. Anderson, E. R. Laws, R. E. Wharen

• The Department of Neurosurgery, University of California, Davis, USA

  J. E. Boggan

• University Neurosurgeons, S.C., Chicago, USA

  L. J. Cerullo

• Western Heart Institute, St. Mary’s Hospital and Medical Center, San Francisco, USA

  M. C. Chan, R. M. Ikeda, G. Lee, D. T. Mason

• Section of Neurosurgery, H.B. 405, University of Chicago Medical Center, Chicago, USA

  G. J. Dohrmann

• Department of Neurological Surgery, University of California, San Francisco, USA

  M. S. B. Edwards

• Istituto di Neurochirurgia, Università di Torino, Torino, Italy

  V. A. Fasano, R. Urciuoli

• Abteilung Allgemeine Neurochirurgie, Neurochirurgische Universitätsklinik, Klinikum der Albert-Ludwigs-Universität, Freiburg i. Br., Federal Republic of Germany

  J. M. Gilsbach, A. Harders

• Department of Neurologic Surgery, Mayo Clinic, Rochester, USA

  P. J. Kelly

• ENEA-Dip. TIB, Divisione Fisica Applicata, C.R.E. Frascati, C.P. 65, Frascati (Roma), Italy

  T. Letardi, A. Renieri

• Houston, USA

  C. R. Neblett

• Division of Neurosurgery, Department of Surgery, UCLA School of Medicine, Los Angeles, USA

  R. W. Rand

• Commonwealth Neurosurgery, Ltd., Norfolk, USA

  I. L. Richmond

• Department of Radiology, University of Michigan Hospitals, Ann Arbor, USA

  J. M. Rubin

• Division of Surgical Oncology, University of California, Los Angeles, USA

  A. W. Silberman

Policies and ethics