Experimental investigations of a manually versus an electrically driven skull drill for bedside usage

Abstract

Background Manual skull drilling is an old but in modern neurosurgery still established procedure which can be applied quickly and universally in emergency situations. Electrical drilling requires more complex equipment and is usually reserved to the Operating Room (OR). It also seems desirable to apply an electrical drill for bedside usage but a suitable product does not exist so far. Method Our experimental study using a manually and an electrically driven skull drill included a total of 40 holes drilled into synthetic biomechanical sheets. Half of the holes were produced with a prototype electrical drilling machine of the company Kaiser Technology and half of them with a traditional manual drill. Different drilling parameters such as the geometry of the borehole, the drilling forces and the drilling vibrations were captured during all experiments. Results The electrical drilling needed higher vertical force by the operators and a longer time to penetrate the sheet. A reason was the relatively lower rotational speed provided by this particular drill. When drilling electrically the vibrations were substantially less which in turn led to a more precise shape of the holes (revealed by observation via a microscope). Conclusions The electrification of bedside drilling can in principle enable emergency craniostomies to be performed with greater ease and accuracy. The power of the electric drive, however, must be at least equivalent to the power of the traditional manual drill. Otherwise, the vertical forces exerted on the scull by the operator become inhibitive. The challenge is to combine cost-efficiency and re-sterilizability of an electrically driven drilling machine which at the same time is small and simple enough to qualify for emergency applications.

Power Drill Craniostomy for Bedside Intracranial Access in Traumatic Brain Injury Patients

“…In brief, the most common injury mechanisms were falls and motor vehicle/motorcycle accidents. Trauma registry ISS scores were categorized into minor/moderate (1-15), serious (16)(17)(18)(19)(20)(21)(22)(23)(24), severe (25-49), and critical/maximum (50-75). Two patients who experienced pre-hospital cardiac arrest were treated with the appropriate resuscitation and return of spontaneous circulation (ROSC).…”

“…For Case 1, initially with the manual twist drill, the operator created worsening depressions of the comminuted fractures due to any exertion of downward force that would be necessary to initialize drilling. The grip form of the power drill converts drilling into a single-handed procedure [20], freeing the non-dominant hand of the operator to provide further stabilization on the drill stop extension. Additionally, the rotational force from the power drill allows for easier engagement with the cortical skull and reduces the translational force.…”

Motor-free telerobotic endomicroscopy for steerable and programmable imaging in complex curved and localized areas

“…In practice, high-speed in-vivo rotating devices are relatively rare, and there are currently no clinical guidelines or consensus on this. The use of a drill in cranial surgery is a reference case, where a rotational speed of less than 600 RPM is recommended to minimize intraoperative secondary damage 70 . On the other hand, preserving image integrity and authenticity is of utmost importance in medical imaging.…”

Safety Analysis of a New Portable Electrical Drill With a Smart Autostop Mechanism for Bedside Cranial Procedures

“…It seems to be more economical than an electrically or pneumatically powered drill. 2 However, electric drills seem to create less vibration than manual ones, 6 , 7 , 9 are usually self-controlled, and have a preadjustable distance holder that limits intracerebral penetration. 2 To use cranial bolts, usually the diameter of the trephination should be fixed, which does not occur with the HD that has a tapered bit, with a variable cortical diameter size.…”