The application of ultrasound in neuroendoscopic procedures: first results with the new tool »NECUP-2« [Upotreba ultrazvuka u neuroendoskopskim procedurama: prvi rezultati s novim uređajem »NECUP-2«]

Jednačak, Hrvoje and Paladino, Josip and Miklić, Pavle and Mrak, Goran and Vukić, Miroslav and Štimac, Tihomir and Klarica, Marijan (2011) The application of ultrasound in neuroendoscopic procedures: first results with the new tool »NECUP-2« [Upotreba ultrazvuka u neuroendoskopskim procedurama: prvi rezultati s novim uređajem »NECUP-2«]. Collegium Antropologicum, 35 (S. 1). pp. 45-49. ISSN 0350-6134

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Abstract

In this paper, our experience with originally constructed Neurosurgical Endoscopic Contact Ultrasound Probe »NECUP-2« in neuroendoscopy is reported. Between June 1997 and June 2007, 132 neuroendoscopic procedures have been performed: 102 endoscopic thrid ventriculostomies (ETV), 15 arachnoid cysts and 5 intraventricular tumours operations. The »NECUP-2« was applied effectively in all cases in which blunt perforation was not possible: 38/102 ETV, 10/10 septostomies, 15/15 arachnoid cysts. In five cases of intraventricular tumours, neuroendoscopic procedure was combined with open microsurgery for tumour removal with preservation of vascular structures. There were no »NECUP-2« related complications. Of postoperative complications, we had liquorrhea (9 patients), and symptoms of meningitis (6 patients). In the follow-up period (6 months to 6 years), we had a patency rate of 80% (50/63 patients). All patients improved in clinical status. According to the first results, it seems that ultrasonic contact probe NECUP-2 presents a new device in neurosurgical armamentarium that can be used in various fields of neurosurgery. With minimal and controlled lesion that is produced at the tip of the probe, it can be used in highly demanding operations such as third ventriculostomy and tumour resection.

Abstract in Croatian

U ovom radu prikazano je naše iskustvo sa originalno konstruiranom »NECUP-2« (Neurosurgical Endoscopic Contact Ultrasound Probe) sondom u neuroendoskopiji. Između lipnja 1997 i lipnja 2007, učinili smo 132 neuroendoskopske procedure: 102 ETV, 10 septstomija, 15 arahnoidalnih cisti i 5 intraventrikularnih tumora. »NECUP-2« je efikasno korišten u svim slučajevima u kojima se nije mogla učiniti tupa perforacija: 38/102 ETV, 10/10 septostomija, 15/15 arahnoidalnih cista. U pet slučajeva intraventrikularnih tumora neuroendoskopija se kombinirala sa sa otvorenom mikrokirurgijom uz očuvanje vaskularnih struktura. Nismo zabilježili komplikacije vezane uz upotrebu »NECUP-2«. Od poslijeoperacijskih komplikacija zabilježene su dvije likvoreje i u šest bolesnika simtpomi meningitisa. U praćenju bolesnika (od 6 mjeseci do 6 godina) zabilježena otvorenost stome od 80% (50/63 bolesnika). Svi bolesnici su imali poboljšan poslijeoperacijski klinički status. Prema prvim rezultatima čini se kako ultrazvučna kontaktna proba »NECUP-2« predstavlja novi uređaj u neurokirurškom armamentarijumu koji se može koristiti u raznim poljima neurokirurgije. Minimalnom i kontroliranom lezijom koja se proizvodi na vrhu probe može se koristiti u visoko zahtijevnim operacijama kao što je treća ventrikulostomija ili resekcija tumora.

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