Development of a Handpiece and Probes for a Microsurgical Ultrasonic Aspirator: Instrumentation and Application

Sawamura, Yutaka; Fukushima, Takanori; Terasaka, Shunsuke; Sugai, Toshiya

doi:10.1097/00006123-199911000-00035

Cited by 30 publications

(21 citation statements)

References 9 publications

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“…6) Recently, the CUSA has been widely used in microneurosurgery, particularly for the removal of tenaciously organized and laminated thrombus within the aneurysm sac, as even direct contact of the CUSA probe with the aneurysm wall will not cause damage. 1,2,5) The present case shows that the CUSA can thin the intraaneurysmal thrombus enough to prevent interference with neck clipping without bleeding. Thrombus evacuation with the CUSA requires special attention to the power of the CUSA.…”

Section: Discussionmentioning

confidence: 60%

Direct Clipping of a Thrombosed Giant Cerebral Aneurysm After Thrombectomy Without Bleeding to Minimize the Temporary Occlusion Time -Technical Case Report-

Sugita

Kinouchi

Nishiyama

et al. 2009

Neurol. Med. Chir.(Tokyo)

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A 75-year-old man was referred to our hospital with a thrombosed giant middle cerebral artery aneurysm manifesting as progressive memory disturbance and disorientation. Magnetic resonance imaging and conventional angiography revealed a partially thrombosed giant aneurysm of the left middle cerebral artery bifurcation and edema of the adjacent brain which had enlarged compared to 3 months before. Surgery was performed through a left frontotemporal craniotomy. After exposure of the aneurysm neck, we tried to apply a clip, which slipped due to the intraaneurysmal thrombus. Intraoperative motor evoked potential monitoring showed decreased amplitude. Therefore, the aneurysm dome was incised and the intraaneurysmal thrombus near the neck was shaved with the ultrasonic aspirator, followed by neck clipping of the aneurysm. The residual thrombus was safely removed. Transient right hemiparesis was observed after surgery, but his memory disturbance gradually improved. Giant thrombosed aneurysm can be treated by reduction of the thrombus from the far side to the lumen to reduce the duration of parent artery occlusion required for clipping.

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Section: Discussionmentioning

confidence: 60%

Direct Clipping of a Thrombosed Giant Cerebral Aneurysm After Thrombectomy Without Bleeding to Minimize the Temporary Occlusion Time -Technical Case Report-

Sugita

Kinouchi

Nishiyama

et al. 2009

Neurol. Med. Chir.(Tokyo)

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“…An ultrasonic aspirator was first used in 1947 for the removal of dental plaques (14) and developed more for dentistry in 1952. In 1978 the ultrasonic bone scalpel was used for the first time in neurosurgery (5,6).…”

Section: Discussionmentioning

confidence: 99%

Is There a Role for an Ultrasonic Bone-Cutting Device in Adult Spinal Deformity: A Safety and Reproducibility Study

et al. 2016

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Background: Ultrasonic bone-cutting devices (UBC) are new cutting tools and have low frequency ultrasonic blade. There is limited data on the safety and effectiveness of using ultrasonic bone-cutting devices in the treatment of adult spinal deformities (ASD). Objectives: This Retrospective review of prospectively collected data was designed to determine if the use of an ultrasonic bonecutting device is safe in the adult spinal deformity population and to compare its effectiveness in blood loss reduction by using a comparison group from a prospective multicenter database of adult spinal deformity patients. Methods: Nineteen consecutive surgical ASD cases in which the UBC was used were compared with 19 propensity-matched cases from a prospective ASD database in which conventional bone cutting instruments were used. The two groups were matched based on age, ASA, and number of levels fused posteriorly. The need for blood transfusion, volume of blood transfusion if required, estimated blood loss (EBL), and total operating time were compared between the two groups. Data were analyzed using non-parametric Mann-Whitney U test and Spearman's Correlation test (P < 0.05). Results: There was no statistically significant difference in any measured parameter between the two groups. While the EBL difference between the two groups (925 mL in the study group vs. 1628 mL in the control group) was not statistically significant (P = 0.142), the 703 mL difference is clinically relevant. In addition, no complications directly related to the use of the UBC were reported. Conclusions: The use of an ultrasonic bone-cutting device was shown to be safe and effective in the surgical treatment of ASD. It resulted in a 43% reduction in EBL, which was clinically relevant and statistically non-significant, without the addition of any complications. We did not identify statistical differences in transfusion rates, EBL, or operative time, which may be due to our small sample size.

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“…In this report, to overcome these limitations and establish a safe and less invasive procedure, we performed laminoplastic laminotomy and hemilaminotomy using the scalpel-type ultrasonic bone curette. This instrument resects bones with oscillation without rolling movement 2,3,13,17) . Because of its longitudinal and torsional oscillating motion, it facilitates bone resection during spinal surgery 7,12,14) .…”

Section: Discussionmentioning

confidence: 99%

“…Spinal cord and root injury have been reported in laminotomy using a threadwire saw 5) . On the other hand, a scalpel-type ultrasonic bone curette, which has recently been introduced in the neurosurgical field, is an instrument for resecting bones with oscillation without rolling movement 2,3,13,17) . It is commonly used for the intracranial surgery.…”

Section: Introductionmentioning

confidence: 99%

Safe and minimally invasive laminoplastic laminotomy using an ultrasonic bone curette for spinal surgery: technical note

et al. 2009

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Development of a Handpiece and Probes for a Microsurgical Ultrasonic Aspirator: Instrumentation and Application

Abstract: This newly developed neurosurgical handpiece with angled probes has great utility for microscopic dissections, because of its small size and light weight.

Cited by 30 publications

References 9 publications

Direct Clipping of a Thrombosed Giant Cerebral Aneurysm After Thrombectomy Without Bleeding to Minimize the Temporary Occlusion Time -Technical Case Report-

Direct Clipping of a Thrombosed Giant Cerebral Aneurysm After Thrombectomy Without Bleeding to Minimize the Temporary Occlusion Time -Technical Case Report-

Is There a Role for an Ultrasonic Bone-Cutting Device in Adult Spinal Deformity: A Safety and Reproducibility Study

Safe and minimally invasive laminoplastic laminotomy using an ultrasonic bone curette for spinal surgery: technical note

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