BACKGROUND: A key aspect of neurosurgery is the challenge of ensuring adequate visualization through brain retraction whilst ensuring that underlying brain remains protected. Self-retaining retractors (SRR) are specially designed for this purpose. Their limitation however is the potential for ischaemic damage that accompanies any pressure on the cerebral cortex. METHODS AND TECHNIQUE: We use balloon tips of Fogarty catheters to provide gentle brain retraction during surgery for skull base and midline tumours as well as aneurysms of anterior circulation. Following completion of the craniotomy and dural opening, the balloon tip is inserted under the frontal or temporal lobes or into the interemispheric fissure, and then inflated. This results in distension of the arachnoid, thereby favouring the dissection process. CONCLUSION: Diverting the brain from operative view with a more elastic, less traumatic, and easily adjustable Fogarty catheter balloon tip is a safe and effective tool that can either act as a substitute for SRR or alternatively minimise their duration of use.
BACKGROUND: A key aspect of neurosurgery is the challenge of ensuring adequate visualization through brain retraction whilst ensuring that underlying brain remains protected. Self-retaining retractors (SRR) are specially designed for this purpose. Their limitation however is the potential for ischaemic damage that accompanies any pressure on the cerebral cortex. METHODS AND TECHNIQUE: We use balloon tips of Fogarty catheters to provide gentle brain retraction during surgery for skull base and midline tumours as well as aneurysms of anterior circulation. Following completion of the craniotomy and dural opening, the balloon tip is inserted under the frontal or temporal lobes or into the interemispheric fissure, and then inflated. This results in distension of the arachnoid, thereby favouring the dissection process. CONCLUSION: Diverting the brain from operative view with a more elastic, less traumatic, and easily adjustable Fogarty catheter balloon tip is a safe and effective tool that can either act as a substitute for SRR or alternatively minimise their duration of use.
Authors: Sun Jay Yoo; Jody Mou; Reena Elizebath; Ananyaa Sivakumar; Rene DeBrabander; Mark Shifman; Kevin Tu; Wataru Ishida; Mohammed Fouda; Amir Manbachi; Alan Cohen Journal: Proc 2021 Des Med Devices Conf DMD2021 (2021) Date: 2021-05-11