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Intraoperative mapping

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https://www.readbyqxmd.com/read/29147631/automated-whole-brain-tractography-affects-preoperative-surgical-decision-making
#1
Hesham Zakaria, Sameah Haider, Ian Lee
Surgery in and around eloquent brain structures poses a technical challenge when the goal of surgery is maximal safe resection. Magnetic resonance imaging (MRI) has revolutionized the diagnosis and treatment of neurological disorders, but tractography still remains limited in terms of utility because of the requisite manual labor and time required combined with the high risk of bias and inaccuracy. Automated whole brain tractography (AWBT) has simplified this workflow, overcoming historical barriers, and allowing for integration into modern neuronavigation...
September 6, 2017: Curēus
https://www.readbyqxmd.com/read/29139243/wide-field-spectrally-resolved-quantitative-fluorescence-imaging-system-toward-neurosurgical-guidance-in-glioma-resection
#2
Yijing Xie, Maria Thom, Michael Ebner, Victoria Wykes, Adrien Desjardins, Anna Miserocchi, Sebastien Ourselin, Andrew W McEvoy, Tom Vercauteren
In high-grade glioma surgery, tumor resection is often guided by intraoperative fluorescence imaging. 5-aminolevulinic acid-induced protoporphyrin IX (PpIX) provides fluorescent contrast between normal brain tissue and glioma tissue, thus achieving improved tumor delineation and prolonged patient survival compared with conventional white-light-guided resection. However, commercially available fluorescence imaging systems rely solely on visual assessment of fluorescence patterns by the surgeon, which makes the resection more subjective than necessary...
November 2017: Journal of Biomedical Optics
https://www.readbyqxmd.com/read/29138078/is-there-an-indication-of-intraoperative-mri-in-subtotal-resection-of-glioblastoma-a-multicenter-retrospective-comparative-analysis
#3
Jan Coburger, Javier Segovia von Riehm, Oliver Ganslandt, Christian Rainer Wirtz, Mirjam Renovanz
INTRODUCTION: Surgery in patients with highly eloquent glioblastoma (GB) remains challenging. OBJECTIVE: To evaluate influence of use of iMRI on extent of resection (EoR), clinical outcome and survival in GB-patients with preoperatively intended subtotal resection (STR). METHODS: We performed a retrospective assessment in 3 neurosurgical centers(2008-2013). All patients with primary GB, unilocular growth, and adjuvant radiochemotherapy in whom a STR was intended were included...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29132268/simplifying-logistics-and-avoiding-the-unnecessary-in-patients-with-breast-cancer-undergoing-sentinel-node-biopsy-a-prospective-feasibility-trial-of-the-preoperative-injection-of-super-paramagnetic-iron-oxide-nanoparticles
#4
A Karakatsanis, H Olofsson, P Stålberg, L Bergkvist, S Abdsaleh, F Wärnberg
PURPOSE: Sentinel node is routinely localized with the intraoperative use of a radioactive tracer, involving challenging logistics. Super paramagnetic iron oxide nanoparticle is a non-radioactive tracer with comparable performance that could allow for preoperative localization, would simplify the procedure, and possibly be of value in axillary mapping before neoadjuvant treatment. The current trial aimed to determine the a priori hypothesis that the injection of super paramagnetic iron oxide nanoparticles in the preoperative period for the localization of the sentinel node is feasible...
November 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/29131021/a-novel-color-fluorescence-navigation-system-for-intraoperative-transcutaneous-lymphatic-mapping-and-resection-of-sentinel-lymph-nodes-in-breast-cancer-comparison-with-the-combination-of-gamma-probe-scanning-and-visible-dye-methods
#5
Norihiro Hokimoto, Takeki Sugimoto, Tsutomu Namikawa, Taku Funakoshi, Toyokazu Oki, Maho Ogawa, Hideo Fukuhara, Keiji Inoue, Takayuki Sato, Kazuhiro Hanazaki
BACKGROUND: This study evaluated the clinical efficacy of a novel imaging system (HyperEye Medical System [HEMS]; Mizuho Corp., Tokyo, Japan) that uses the near-infrared (NIR) fluorescence of indocyanine green to analyze sentinel lymph node (SLN) biopsies for the staging of breast cancer. METHODS: This study enrolled 91 patients with histologically confirmed breast cancer that was clinically node negative with a tumor size <3 cm. We compared SLN identification rates between HEMS and conventional methods (gamma probe scanning using a colloidal radioisotope [RI] and a blue dye method) by analyzing the relationships of lymphatic to axillary lesions and SLNs...
November 10, 2017: Oncology
https://www.readbyqxmd.com/read/29130551/a-localized-pallidal-physiomarker-in-cervical-dystonia
#6
Wolf-Julian Neumann, Andreas Horn, Siobhan Ewert, Julius Huebl, Christof Brücke, Colleen Slentz, Gerd-Helge Schneider, Andrea A Kühn
OBJECTIVE: Deep brain stimulation (DBS) allows for direct recordings of neuronal activity from the human basal ganglia. In Parkinson's disease, a disease-specific physiomarker was identified that is now used to investigate adaptive closed-loop stimulation in first studies. In dystonia such a physiomarker is missing. METHODS: Pallidal oscillations were recorded from 153 contact pairs in 27 patients. We investigated whether power amplitudes in theta and beta bands correlate with dystonic symptom severity across patients...
November 11, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29126367/t2-mapping-of-acetabular-cartilage-in-patients-with-femoroacetabular-impingement-at-3-tesla-comparative-analysis-with-arthroscopic-findings
#7
Tobias Hesper, Christina Neugroda, Christoph Schleich, Gerald Antoch, Harish Hosalkar, Rüdiger Krauspe, Christoph Zilkens, Bernd Bittersohl
Objective To evaluate the diagnostic accuracy of T2*-mapping for detecting acetabular cartilage damage in patients with symptomatic femoroacetabular impingement (FAI). Design A total of 29 patients (17 females, 12 males, mean age 35.6 ± 12.8 years, mean body mass index 25.1 ± 4.1 kg/m(2), 16 right hips) with symptomatic FAI underwent T2* MRI and subsequent hip arthroscopy. T2* values were obtained by region of interest analysis in seven radially reformatted planes around the femoral neck (anterior, anterior-superior, superior-anterior, superior, superior-posterior, posterior-superior, posterior)...
November 1, 2017: Cartilage
https://www.readbyqxmd.com/read/29125414/resection-of-gliomas-deemed-inoperable-by-neurosurgeons-based-on-preoperative-imaging-studies
#8
Derek G Southwell, Harjus S Birk, Seunggu J Han, Jing Li, Jeffrey W Sall, Mitchel S Berger
OBJECTIVE Maximal safe resection is a primary objective in the management of gliomas. Despite this objective, surgeons and referring physicians may, on the basis of radiological studies alone, assume a glioma to be unresectable. Because imaging studies, including functional MRI, may not localize brain functions (such as language) with high fidelity, this simplistic approach may exclude some patients from what could be a safe resection. Intraoperative direct electrical stimulation (DES) allows for the accurate localization of functional areas, thereby enabling maximal resection of tumors, including those that may appear inoperable based solely on radiological studies...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29109639/evaluation-of-the-efficacy-of-desflurane-with-or-without-labetalol-for-hypotensive-anesthesia-in-middle-ear-microsurgery
#9
Neha Gupta, Vandana Talwar, Smita Prakash, Achyut Deuri, Anoop Raj Gogia
Background and Aims: Hypotensive anesthesia technique is used to reduce intraoperative bleeding and to improve the visibility of the operative field. The aim was to evaluate the efficacy of desflurane with and without labetalol for producing hypotensive anesthesia. Material and Methods: Sixty adult patients undergoing elective middle ear surgery were administered general anesthesia and randomly divided into two groups - Group D and Group L. The target mean arterial pressure (MAP) was 55-65 mmHg during hypotensive period...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29107433/-use-of-indocyanine-green-angiography-in-oncological-and-reconstructive-breast-surgery
#10
S Struk, J-F Honart, Q Qassemyar, N Leymarie, B Sarfati, H Alkhashnam, C Mazouni, F Rimareix, F Kolb
The Indocyanine green (ICG) is a soluble dye that is eliminated by the liver and excreted in bile. When illuminated by an near-infrared light, the ICG emits fluorescence in the near-infrared spectrum, which can be captured by a near-infrared camera-handled device. In case of intravenous injection, ICG may be used as a marker of skin perfusion. In case of interstitial injection, it may be useful for lymphatic network mapping. In oncological and reconstructive breast surgery, ICG is used for sentinel lymph node identification, to predict mastectomy skin flap necrosis, to assess the perfusion of free flaps in autologous reconstruction and for diagnosis and treatment of upper limb secondary lymphedema...
October 26, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/29106918/use-of-intraoperative-nuclear-imaging-leads-to-decreased-anesthesia-time-and-real-time-confirmation-of-lesion-removal
#11
Joseph C Fusco, Brittani K N Seynnaeve, Alexander J Davit, Michael R Czachowski, Judith M Joyce, Barbara A Gaines, Marcus M Malek
BACKGROUND: Lymphatic mapping to guide sentinel lymph node biopsy (SLNB) typically requires lymphoscintigraphy prior to surgery. In young pediatric patients, this process often requires intubation in the nuclear medicine suite followed by transport to the operating room (OR). METHODS: We reviewed 14 pediatric cases in which a portable nuclear imaging camera was utilized to perform the entirety of the SLNB in the OR. RESULTS AND CONCLUSION: This method, utilizing intraoperative nuclear imaging, helped to confirm removal of the sentinel lymph node in real time, decreased anesthesia time, and avoided transport of a sedated or intubated child...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29105818/simplified-profunda-artery-perforator-pap-flap-design-using-power-doppler-ultrasonography-pdu-a-prospective-study
#12
Andreas Kehrer, Ming-Yi Hsu, Yu-Ting Chen, Neil S Sachanandani, Chung-Kan Tsao
INTRODUCTION: Optimal design of PAP flaps requires precise perforator mapping. In a systematic review, Doppler ultrasonography demonstrated the highest sensitivity and positive predictive value (PPV). We present a prospective study of PAP flap design comparing PDU, handheld Doppler (HHD), and clinical findings. METHODS: From May to July 2016, 12 head and neck cancer patients receiving PAP flaps were examined with PDU and HHD. We used PDU to evaluate number, course, emergence point, peak systolic velocity (PSV), and arterial diameter of perforators...
November 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/29105013/is-non-awake-surgery-for-supratentorial-adult-low-grade-glioma-treatment-still-feasible
#13
REVIEW
Hugues Duffau
In this short review, the author performs a database search, summarizes, and discusses studies that provide information on the need to perform awake surgery to preserve quality of life/return to work of adult patients who undergo resection for a supratentorial low-grade glioma (LGG). Based upon the currently available data, the author concludes that in LGG, patients with no or only mild deficits at diagnosis, non-awake surgery can no longer be achieved. Indeed, awake craniotomy with intrasurgical electrical mapping has resulted in an increase of the extent of resection and overall survival in LGG...
November 6, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/29104660/target-controlled-infusion-of-propofol-and-remifentanil-combined-with-dexmedetomidine-reduces-functional-endoscopic-sinus-surgery-bleeding
#14
Deng-Feng Ding, Li-Fang Wu, Ping Wang, Yuan-Xu Jiang, Yao-Wen Luo, Zhong-Liang Dai, Xue-Ping Zhang, Ya-Li Li
The aim of the present study was to investigate the effects of target-controlled infusion (TCI) of propofol and remifentanil combined with dexmedetomidine on functional endoscopic sinus surgery (FESS) bleeding and surgical field. 62 patients scheduled to undergo FESS were randomly divided into experimental group (intravenous 0.5 µg kg(-1) h(-1) dexmedetomidine after 0.5 µg kg(-1) bolus within 15 min until the end of surgery) or control group (intravenous saline administration at the same dose). All patients underwent endotracheal intubation under general anesthesia with TCI of propofol and remifentanil for anesthesia induction and maintenance...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29092758/navigation-guided-resection-of-maxillary-tumours-the-accuracy-of%C3%A2-computer-assisted-surgery-in-terms-of-control-of-resection-margins%C3%A2-a-feasibility-study
#15
Achille Tarsitano, Francesco Ricotta, Gennaro Baldino, Giovanni Badiali, Angelo Pizzigallo, Valerio Ramieri, Piero Cascone, Claudio Marchetti
INTRODUCTION: Surgical treatment of maxillary tumours is often highly complex. The three-dimensional anatomy of the mid-face renders both correct intraoperative orientation and adequate oncological safety difficult to obtain. Recently, computer-assisted techniques and intraoperative navigation have been applied to oncological surgery treating head and neck cancer. However, only a few studies have explored whether preoperative virtual resection planning and intraoperative control of resection margins allow assessment of the surgical margins of the tumour...
September 30, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29078572/continuous-intraoperative-vagus-nerve-stimulation-for-monitoring-of-recurrent-laryngeal-nerve-during-minimally-invasive-esophagectomy
#16
REVIEW
Ian Wong, Daniel K H Tong, Raymond K Y Tsang, Claudia L Y Wong, Desmond K K Chan, Fion S Y Chan, Simon Law
For squamous cell carcinoma of the esophagus, extended mediastinal lymphadenectomy especially around the bilateral recurrent laryngeal nerves (RLN) is associated with high risk of nerve injury. This does not only result in hoarseness of voice, increase the chance of pulmonary complications, but would also affect the quality of life of patients in the long term. Methods to improve safety of lymphadenectomy are desirable. Continuous intraoperative nerve monitoring (CIONM) based on a system using vagus nerve stimulation was tested...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29076487/-endoscopic-tattooing-of-colorectal-neoplasms-and-laparoscopic-surgery-technical-aspects-and-recommendations
#17
B N Bashankaev, K V Shishin, V V Veselov, A A Mitrakov, E V Velikanov
Accurate mapping of colorectal neoplasms is needed in many clinical situations. Intraoperative mapping of small lesions previously detected by endoscopy is often challenging, especially during laparoscopic surgery. Tumor location assessed during colonoscopy may be inaccurate because of limitations of the procedure. Small flat neoplasms with signs of invasiveness, which are hard to detect by palpation, hold a special place. The same situation is observed for nonradical endoscopic resection of malignant polyps or early cancer, when visual examination shows that the tumor masses have been completely resected but histological examination reveals the positive lateral or horizontal resection margin...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29073613/impact-of-the-flotrac-vigileotm-monitoring-on-intraoperative-fluid-management-and-outcome-after-liver-resection
#18
Enrico Giustiniano, Fabio Procopio, Nadia Ruggieri, Stefania Grimaldi, Guido Torzilli, Ferdinando Raimondi
BACKGROUNDS: Perioperative fluid-therapy is a still a debated issue. In hepatic surgery, volume load must be strictly monitored to assure both a safe hemodynamics and low central venous pressure (CVP) to limit the backflow bleeding. Retrospectively, we compared intraoperative fluid management before and after the adoption of a semi-invasive hemodynamic monitoring. METHODS: We compared patients submitted to liver resection monitored by FloTrac/VigileoTM (group A) vs...
October 26, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29068896/updates-in-head-and-neck-reconstruction
#19
Rene D Largo, Patrick B Garvey
LEARNING OBJECTIVES: After reading this article, the participant should: 1. have a basic understanding of virtual planning, rapid prototype modeling, 3D printing, and computer-assisted design and manufacture, 2. understand the principles of combining virtual planning and vascular mapping, 3. understand principles of flap choice and design in preoperative planning of free osteocutaneous flaps in mandible and midface reconstruction, and 4. discuss advantages and disadvantages of computer-assisted design and manufacture in reconstruction of advanced oncologic mandible and midface defects...
October 13, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29067499/prognosis-of-surgical-treatment-of-the-tethered-cord-syndrome-in-children
#20
Kirill Sysoev, Arsen Tadevosyan, Konstantin Samochernykh, William Khachatryan
PURPOSE: The aim of this study was to identify the factors relevant to the prognosis of the outcome of the surgical treatment of the tethered cord syndrome (TCS). METHODS: The results of surgical treatment performed on 58 children with TCS were analyzed, with follow-up periods ranging from 6 months to 5 years. The data of preoperative clinical and instrumental examinations, as well as those of intraoperative electrophysiological diagnostics and morphometry, were compared with the dynamics of the TCS clinical presentation...
October 24, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
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