The invention solves the design and fabrication of narrowly dedicated surgical photoplethysmograph suitable for interoperative installation above optical channel. The invention is used for non-invasive microcirculation monitoring of the optic nerve. The device’s real-time analysis of measured photoplethysmographic waveform provides a neurosurgeon a feedback about the adequacy of its mechanical manipulation of the optic nerve. By such, the invention protects patient’s vision from potential damage due to inevitable surgical procedure.
F.33 Slovenian patent
COBISS.SI-ID: 10955348Background. The choice of endoscopic expanded endonasal approach introduces the possibility of improved gross total resection of craniopharyngioma while minimizing surgical morbidity in a significant subset of patients. Methods. From our trans-sphenoidal surgical series of 331 cases, we retrospectively reviewed visual, endocrine and neuro-cognitive outcomes in the first consecutive eight patients (median age 63 years; range 4773 years) with newly diagnosed supradiaphragmatic craniopharyngioma (median tumour height 23 mm; range 1534 mm), removed by expanded endonasal approach (median follow-up 27 months; range 1069 months). Gross total resection was attempted in all patients. Results. Gross total resection was achieved in 6 of 8 patients. Visual improvement was present in 6 of 8 patients of patients or in 14 of 16 eyes. New endocrinopathy, including diabetes insipidus, appeared in 5 of 8 patients. Stalk was preserved in 4 patients. Cognitive decline was present in 2 cases. Five of 8 patients retained previous quality of life. Conclusions. Our early outcome results are comparable to the recent few expanded endonasal approach series, except for the incidence of new endocrinopathy and cerebrospinal fluid leak rate. This was influenced by higher number of transinfundibular tumours in our series, where stalk preservation is less likely, and not using nasoseptal flap or gasket closure in the first half of cases. Including data from the literature and ours, expanded endonasal approach shows a trend for improved gross total resection rate with less morbidity, more obviously for visual outcome and quality of life than for endocrine outcome. However, validity of expanded endonasal approach should be confirmed in a larger number of patients with a longer follow-up period.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 1015980Introduction. Brain retraction is necessary to approach deep-seated intra-axial lesions. The incidence of brain retraction injury remains high. We describe a transparent PVC tubular retract or technique for intraventricular lesion. Patients and methods. The technique was used in a 75-yr old patient with a 3x3 cm tumor in the frontal horn of the left lateral ventricle. A 1.5 cm skin incision was made inside the forehead wrinklesupracilliary followed by 1 cm trephination.The polyvinyl sheet was cut in 7x 7 cm square piece and rolled into a tubular shape. We inserted theroll wrapped around neuronavigational probe via minimal brain incision, expanded the inserted rollwith a balloon dilatation to 7 mm of diameter and kept this surgical corridor without usual spatulasduring bimanual microsurgical lesionectomy under endoscopic visualization. Results. Subependimoma was completely removed from the frontal horn, foramen of Monroe was released, septum was perforated. There was no hematoma. The patient was without neurological problems. The cosmetic effect was excellent. T2/FLAIR MRI scan revealed only a minimal white matter injury along the surgical corridor. Conclusions. The expandable tubular retractor in conjunction with frameless neuron avigation provided a safe access and an excellent visualization of the underlying lesion. The tubular shape of the retractor permitted the use of standard microsurgical techniques through minimally invasive craniotomies without putting extra pressure on the brain tissue.
F.08 Development and manufacture of a prototype
COBISS.SI-ID: 31075545Removal of adenomas from parasellar space is thought to be impossible and conjoined with cranial nerve craniopathy. Residual parasellar adenomas are thus stereotactically radiated. We explained the principle of extendend endonasal approach as the first line treatment for pituitary adenomas invading into the cavernous sinus - evidenced from 20 own cases, who suffered remarkably small morbidity.
B.04 Guest lecture
COBISS.SI-ID: 1497004