Microsurgery Applied to Neurosurgery focuses on microsurgical approaches to cerebrospinal lesions, including plastic surgery, suturing techniques, instruments for microsurgery, and microsurgical operations. The manuscript first offers information on the history of microsurgery and the operating microscope. Discussions focus on bipolar electric coagulation, plastic surgery, peripheral nerves, clinical application, binocular diploscope, automatic microscope stand, sterile covering of the microscope, and magnification. The text also elaborates on the instruments for microsurgery and suturing techniques. The publication takes a look at experimental microsurgical operations in animals and reconstructive and constructive surgery of the cerebral arteries in man. The manuscript also ponders on intracranial tumors and transnasal-transsphenoidal approach to the pituitary gland. Topics include transsphenoidal approach, suboccipital transmeatal approach, spinal tumors, and preoperative radiological study. The manuscript is a dependable reference for health professionals and readers interested in microsurgery.
Inhalt
Table of Contents
Foreword
Introduction
References
Chapter 1 A History of Microsurgery
Microangeional or Microvascular Surgery
Neurosurgery
Bipolar Electric Coagulation
Microinstruments
Peripheral Nerves
Plastic Surgery
Clinical Application
References
Chapter 2 A. The Operating Microscope
The Operating Microscope and its Attachments
The Binocular Operating Microscope from the Surgical Standpoint
The Binocular Diploscope
The Electrically Driven Binocular Monoscope (ZEISS I)
The Zoom Microscope (ZEISS II)
The Automatic Microscope Stand
Directions for Use of the Operating Microscope
The Objective
The Eyepiece (ocular lens)
Positioning of the Microscope at the Start of the Operation
The Eyepiece Tube (ocular tube)
Magnification
Sterile Covering of the Microscope
Attachment for Still and Cine Cameras
Technical Details of the Television Camera for Operating Microscopes
References
B. Instruments for Microsurgery
Forceps
Scissors
Clamps
Curettes and Dissectors
Forceps and Punches
Scalpels and Hooks
Needle Holder
Probes
Irrigator
Counterpressor ('micro-fork')
Retractors
Suckers
Drills
Swab Material
Rubber Strips (Dam)
Ligature Carrier
Bipolar Coagulation in Microsurgery
The Author's Experience with the Bipolar Coagulator of Malis
Instrumentation for Transsphenoidal Microsurgery of the Pituitary
Instrumentation for Otoneurosurgery
References
Plastic Tubes and Plastic T-Tubes
References
C. Suturing Techniques
Stapler
References
Adhesives
References
Microlaser and Micro-Electrocoaptation
References
Suture Material
Size of Thread
Needles
Suture Technique
References
D. Future Developments
The Microscope
Combination of Microscope, Television and X-ray Image Amplifiers
Instruments
References
Chapter 3 Experimental Microsurgical Operations in Animals
Special remarks
Surgical Exercises on Rats
Carotid Artery
Half-ring bypass graft
Aorta and Vena Cava
Operations on the Femoral Artery (Rabbit, Cat)
Longitudinal Arteriotomy
Introduction of the Tube
Suture Technique
End-to-end Anastomosis (Termino-Terminal Anastomosis)
End-to-side Anastomosis (Termino-Lateral Anastomosis)
Duplication
Bridge Transplantation (Interposition)
Operations on the Common Carotid Artery (Rabbit, Cat)
Elaboration of Work Conditions
Transcervical-transclival Exploration of the Basilar Artery in the Rabbit, Cat and Do
Follow-up Angiography
Autopsy
Operations on Rhesus Monkeys: Transoral Clivectomy
Operations in the Middle Cerebral Artery (Dog)
Extracranial-intracranial Anastomoses: Anastomosis between the Superficial Temporal
Artery and the Middle Cerebral Artery (Dog)
Bypass between the Common Carotid Artery and the Middle Cerebral Artery (Dog)
Pre- and Postoperative Management and Anesthesia in Laboratory Animals
Rabbits
Dogs
Follow-up Angiography
Summary of the Surgical and Physiological Problems of Vascular Surgery
References
Chapter 4 Reconstructive and Constructive Surgery of the Cerebral Arteries in Man
A. The Cerebral Vasculature
Nutrition
The Relationship between Morphology and Flow
References
B. Diagnosis and Indications for Operations in Cerebrovascular Occlusive Disease
Reconstructive Operations on the Cerebral Arteries
Constructive Operations on the Cerebral Blood Vessels
References
C. Aneurysms, Arteriovenous Malformations and Fistulae
1. Operations on Saccular Aneurysms
2. Operations on Intracranial Arteriovenous Malformations
References
3. Operations on Caroticocavernous Fistulae
References
Chapter 5 A. Intracranial Tumors
Sellar and Parasellar Tumors
The Transsphenoidal Approach
The Subfrontal Approach
Craniopharyngioma
Sphenoid-wing Meningiomas
Clivus Tumors
Acoustic Neurinomas
Subtemporal-transpetrosal Approach
Transtentorial Approach
Translabyrinthine Removal of the Relatively Small Tumor
Combined Translabyrinthine and Suboccipital Approach for Larger Tumors
Suboccipital-transmeatal Approach
Other Tumors of the Posterior Fossa
References
B. Cranial Nerve Lesions
Trigeminal Neuralgia
Transtentorial Approach
Spasmodic Torticollis
References
Chapter 6 A. Vertebral Column and Spinal Cord Lesions
Spinal Arteriovenous Malformation
Spinal Tumors
Extradural Tumors
Intradural-Extramedullary Tumors
Cauda Equina Tumors
Meningocele-Meningomyelocele
Intramedullary Tumors
References
Cervical Disc Herniation
B. Peripheral Nerve Lesions
References
Chapter 7 Transnasal-transsphenoidal Approach to the Pituitary Gland (J. Hardy)
Introduction
Preoperative Radiological Study
The Sellar Type
The Presellar Type
The Conchal Type
Preparation and Positioning
Techniques
The Subnasal Midline Transsphenoidal Approach
Microsurgical Selective Removal of Intrapituitary Microadenoma
Summary
References
Chapter 8 Oto-neurosurgical Operations: Transtemporal Extralabyrinthine Operations on the Internal Auditory Canal, the Eighth and the Seventh Cranial Nerves
The transtemporal Extralabyrinthine Approach to the Internal Auditory Canal
References
A. Exploration of the Internal Auditory Canal in Cases of Suspected Intrameatal Acoustic Neurinoma
Conclusion
References
B. Operations on the Vestibular Nerve 203
1. Selective Sectioning of the Vestibular Nerve (Vestibular Neurotomy)
Conclusion
2. Excision of a Segment of the Vestibular Nerve, Including the Vestibular Ganglion(Vestibular Neurectomy)
Conclusion
References
C. Operations on the Cochl…