Microsurgical Basics and Bypass Techniques

Microsurgical Basics and Bypass Techniques

by Evgenii Belykh (Author), Nikolay L. Martirosyan (Author), M. Yashar Kalani (Author), Peter Nakaji (Author)

A step-by-step manual on fundamental microsurgical bypass techniques young neurosurgeons need to master!

All neurosurgeons must undergo rigorous training in the laboratory and practice bypass techniques repetitively before performing microneurosurgery on a patient. Microsurgical Basics and Bypass Techniques by Evgenii Belykh, Nikolay Martirosyan, M. Yashar S. Kalani, and Peter Nakaji is a comprehensive yet succinct manual on fundamental laboratory techniques rarely included in clinical textbooks. The resource simplifies repetitive microsurgical practice in the laboratory by providing a menu of diverse, progressively challenging exercises.

Step-by-step instructions accompanied by easy-to-understand illustrations, expert commentary, and videos effectively bridge the gap between laboratory practice and operating room performance. The book starts with an opening chapter on four founding principles of microsurgical practice inherited from great thinkers and concludes with a chapter featuring cerebrovascular bypass cases. Chapters 2-8 offer a complete one-week curriculum, with a different lab exercise each day, focused on learning basic microsurgery skills.

Key Features

Twenty-six videos cover a wide array of topics – from diverse methods for holding instruments and suturing techniques – to end-to-end, end-to-side, and side-to-side anastomosis procedures

High quality color illustrations clearly demonstrate basic techniques

Practical laboratory exercises include how to organize a microsurgical laboratory, essential training and skills, basic arterial and deep-field anastomoses, kidney autotransplantation, supermicrosurgery, and aneurysm clipping

Invaluable tips such as preventing bypass errors and applying laboratory skills to neurosurgical practice

This is an essential microsurgical learning and teaching guide for neurosurgical residents on how to perform basic bypass and anastomoses procedures step by step.

Part of the Fundamental Skills in Neurosurgery Series, Series Editors: Peter Nakaji, Vadim A. Byvaltsev, and Robert F. Spetzler.

This book includes complimentary access to a digital copy on https://medone.thieme.com.

Microsurgical clipping of previously ruptured, coiled aneurysms

 

A total of 53 patients from Phoenix and San Francisco, who initially presented with a subarachnoid hemorrhage and underwent surgical clipping of a previously coiled intracranial aneurysm between December 1997 and December 2014 were studied. Clinical features, hospital course, and preoperative and most recent functional status (Glasgow Outcome Scale score) were reviewed retrospectively.

The mean time interval from coiling to clipping was 2.6 years, and mean follow-up was 5.5 years (range, 0.1-14.7 years). Five patients (9.8%) presented with rebleed prior to clipping. Most patients (79.3%, 42/53) experienced good neurologic outcomes. Most showed no change (81%, 43/53) or improvement (13%, 7/53) in functional status after microsurgical clipping. One patient (2%) deteriorated clinically, and there were 2 mortalities (4%).

Microsurgical clipping of previously ruptured, coiled aneurysms is a promising treatment method with favorable clinical outcomes 1).1) Nisson PL, Meybodi AT, Roussas A, James W, Berger GK, Benet A, Lawton MT. Surgical Clipping of Previously Ruptured, Coiled Aneurysms: Outcome Assessment in 53 Patients. World Neurosurg. 2018 Dec;120:e203-e211. doi: 10.1016/j.wneu.2018.07.293. Epub 2018 Aug 23. PubMed PMID: 30144619.

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