Electromagnetic field system for transsphenoidal surgery on recurrent pituitary lesions—technical note

Abe, Takumi; Tanioka, Daisuke; Sugiyama, Koichi; Kawamo, Michiari; Murakami, Kozo; Izumiyama, Hitoshi

doi:10.1016/j.surneu.2006.02.050

Cited by 6 publications

(6 citation statements)

References 12 publications

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“…As most of these electrosurgical instruments are based on unique principles, they have to be carefully evaluated with respect to the possibility of added functionality and efficacy as a surgical adjunct [4,7-11]. …”

Section: Introductionmentioning

confidence: 99%

Predictive factors for beneficial application of high-frequency electromagnetics for tumour vaporization and coagulation in neurosurgery

et al. 2008

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Objective: To identify preoperative and intraoperative factors and conditions that predicts the beneficial application of a high-frequency electromagnetic field (EMF) system for tumor vaporization and coagulation. Methods:One hundred three subsequent patients with brain tumors were microsurgically treated using the EMF system in addition to the standard neurosurgical instrumentarium. A multivariate analysis was performed regarding the usefulness (ineffective/useful/very helpful/essential) of the new technology for tumor vaporization and coagulation, with respect to tumor histology and location, tissue consistency and texture, patients' age and sex. Results:The EMF system could be used effectively during tumor surgery in 83 cases with an essential contribution to the overall success in 14 cases. In the advanced category of effectiveness (very helpful/essential), there was a significant difference between hard and soft tissue consistency (50 of 66 cases vs. 3 of 37 cases). The coagulation function worked well (very helpful/essential) for surface (73 of 103 cases) and spot (46 of 103 cases) coagulation when vessels with a diameter of less than one millimeter were involved. The light-weight bayonet hand piece and long malleable electrodes made the system especially suited for the resection of deep-seated lesions (34 of 52 cases) compared to superficial tumors (19 of 50 cases).The EMF system was less effective than traditional electrosurgical devices in reducing soft glial tumors. Standard methods where also required for coagulation of larger vessels. Conclusion:It is possible to identify factors and conditions that predict a beneficial application of high-frequency electromagnetics for tumor vaporization and coagulation. This allows focusing the use of this technology on selective indications.

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Section: Introductionmentioning

confidence: 99%

Predictive factors for beneficial application of high-frequency electromagnetics for tumour vaporization and coagulation in neurosurgery

et al. 2008

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“…In addition, repeated TSS can be performed when there is residual tumor, growth of residual tumor, and tumor relapse after surgery. [1][2][3][4][5][6][7][8][9][10] However, the surgical anatomic relationships when performing repeated TSS are different from the first TSS. After the first TSS, anatomic markers are damaged, leading to unclear anatomic structures.…”

mentioning

confidence: 99%

“…In addition, there are scar tissues, mucoceles, and artificial materials in the sphenoid sinus. 2,5,11 Thus, during repeated TSS, it is difficult to direct surgical approach exactly to the correct anatomic structure. 5,7 Thus, the risk and the tumor residual rate of repeated TSS are higher than the first TSS.…”

mentioning

confidence: 99%

“…2,5,11 Thus, during repeated TSS, it is difficult to direct surgical approach exactly to the correct anatomic structure. 5,7 Thus, the risk and the tumor residual rate of repeated TSS are higher than the first TSS. 12 Several studies have reported the technique of repeated TSS, such as TSS under endoscope, 1,9,11 TSS under microscope, 2,5,7,13 and endoscopy-assisted microsurgery.…”

mentioning

confidence: 99%

“…5,7 Thus, the risk and the tumor residual rate of repeated TSS are higher than the first TSS. 12 Several studies have reported the technique of repeated TSS, such as TSS under endoscope, 1,9,11 TSS under microscope, 2,5,7,13 and endoscopy-assisted microsurgery. 13 Most reports regarding repeated TSS focused on the superiority of TSS surgery under endoscope over TSS surgery under microscope.…”

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confidence: 99%

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Repeated Transsphenoidal Surgery for Resection of Pituitary Adenoma

Wang

Xiao²,

Wang³

et al. 2015

Journal of Craniofacial Surgery

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To investigate the surgical strategy of repeated microscopic transsphenoidal surgery (TSS) for treatment of pituitary adenoma, surgical techniques and treatment outcomes for 29 patients with pituitary adenoma were reviewed and analyzed. There were 17 patients who underwent TSS 18 times and 12 patients who underwent TSS 13 times. The interval between each TSS ranged from 3 months to 18 years, with a median time of 4 years. The tumor height was 15 to 45 mm on the last surgery. Among the 29 patients, 16 patients underwent total tumor resection, 11 patients underwent subtotal resection, and 2 patients underwent partial resection. Cerebrospinal fluid leak occurred in 10 patients. Among 24 patients who were followed up effectively, 1 patient developed abducens paralysis after surgery, 1 patient had chronic diabetes insipidus, and 1 patient received steroid-dependent alternative treatment. The repeated TSS may present satisfied outcomes in experienced hands. The upper edge of the posterior choanae should be identified to ensure the right orientation. The openings of the anterior wall of the sphenoid sinus and the sellar floor should be appropriately expanded to improve tumor exposure. The artificial materials should be identified and removed carefully. Intraoperative cerebrospinal fluid leakage should be managed well.

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