Navegando por Palavras-chave "microcirurgia"
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- ItemAcesso aberto (Open Access)Desenvolvimento de protótipo para aplicação do laser de CO2 na laringe humana a curtas distâncias(ABORL-CCF Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial, 2002-03-01) Morgado, Plínio F. [UNIFESP]; Wagner, Paulo [UNIFESP]; Neves, Luciano R. [UNIFESP]; Pontes, Paulo A. De L. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Laser endolaryngeal surgery has been performed with 350 and 400mm focal length (f ) lenses which converge the laser beam to a minimum spot size, called beam waist. The beam waist size can be described as: 2omega0 =lambdaf /pw², where lambda is the CO2 wavelength and 2omega is the beam diameter. We developed an optical system which produces a very small beam waist. This small shaft of laser is delivered precisely on the target resulting in a reduced impact spot size enhancing precision and lessening surrounding tissue trauma on laryngeal surgery. Aim: To present an optical system which delivers the laser beam at a small distance from the human glottis. Study design: Clinical trial. Material and Methods: The manufactured prototype has two metallic cylindrical shafts joined in a 135º angle from the horizontal. A coated mirror positioned in its joint change the ray path in the same angle. Two coated lenses converge the laser to a calculated beam waist. The hand piece was coupled to the laser articulated arm and the system was set to 0.5 - 2.0 W at 0.05 sec. exposure time. Laryngeal exposure was achieved with the angled videolaryngoscopy. Three patients with vocal fold polyp underwent laser surgery with the technique above described. Results: A beam waist ranging from 200 to 250 mum was obtained (lambdaCO2 = 10,6 mum). The technique offered adequate laryngeal exposure and satisfactory image quality for a proper laser application. No technical difficulties nor major bleeding or mucosal charring was observed during the treatment. No excessive scarring was observed in a two-month follow-up laryngoscopy. Conclusion: The developed prototype produced very small laser shafts which are useful in the treatment of vocal fold polyps.
- ItemAcesso aberto (Open Access)The far-lateral craniotomy: tips and tricks(Academia Brasileira de Neurologia - ABNEURO, 2014-09-01) Chaddad Neto, Feres Eduardo Aparecido [UNIFESP]; Doria-netto, Hugo Leonardo; Campos Filho, José Maria De; Reghin Neto, Mateus; Rothon Jr, Albert L; Oliveira, Evandro De; Universidade Federal de São Paulo (UNIFESP); Hospital Real e Benemérita Sociedade Portuguesa de Beneficência Instituto de Ciências Neurológicas Laboratório de Microcirurgia; Departamento de Neurocirurgia Vascular; Hospital Brigadeiro Departamento de Neurocirurgia Vascular; University of Florida Department of Neurosurgery; Universidade Estadual de Campinas (UNICAMP)This article intends to describe in a didactical and practical manner the suboccipital far-lateral craniotomy. This is then basically a descriptive text, divided according to the main stages involved in this procedure, and that describes with details how the authors currently perform this craniotomy.
- ItemAcesso aberto (Open Access)Head positioning for anterior circulation aneurysms microsurgery(Academia Brasileira de Neurologia - ABNEURO, 2014-11-01) Chaddad Neto, Feres Eduardo Aparecido [UNIFESP]; Doria-netto, Hugo Leonardo; Campos-filho, José Maria De; Ribas, Eduardo Santamaria Carvalhal; Ribas, Guilherme Carvalhal; Oliveira, Evandro De; Universidade Federal de São Paulo (UNIFESP); Real e Benemérita Associação Portuguesa de Beneficência Instituto de Ciências Neurológicas Laboratório de Microcirurgia; Sociedade Brasileira de Neurocirurgia Departamento de Neurocirurgia Vascular; Hospital Brigadeiro Departamento de Neurocirurgia Vascular; Universidade de São Paulo (USP); Hospital Beneficência Portuguesa; Universidade Estadual de Campinas (UNICAMP)Objective To study the ideal patient's head positioning for the anterior circulation aneurysms microsurgery. Method We divided the study in two parts. Firstly, 10 fresh cadaveric heads were positioned and dissected in order to ideally expose the anterior circulation aneurysm sites. Afterwards, 110 patients were submitted to anterior circulation aneurysms microsurgery. During the surgery, the patient's head was positioned accordingly to the aneurysm location and the results from the cadaveric study. The effectiveness of the position was noted. Results We could determine mainly two patterns for head positioning for the anterior circulation aneurysms. Conclusion The best surgical exposure is related to specific head positions. The proper angle of microscopic view may minimize neurovascular injury and brain retraction.
- ItemAcesso aberto (Open Access)Pretemporal craniotomy(Academia Brasileira de Neurologia - ABNEURO, 2014-02-01) Chaddad Neto, Feres Eduardo Aparecido [UNIFESP]; Dória-netto, Hugo Leonardo; Campos Filho, José Maria; Reghin Neto, Mateus; Oliveira, Evandro; Universidade Federal de São Paulo (UNIFESP); Instituto de Ciências Neurológicas; Hospital Beneficência Portuguesa de São Paulo; Universidade Estadual de Campinas (UNICAMP); Hospital Beneficência Portuguesa Instituto de Ciências NeurológicasThis paper aims to describe the performance of the pretemporal craniotomy performed didactically from 2002 to 2012 in eighty patients. It is therefore a fundamentally descriptive text, organized in the sequence of the main stages in which such a craniotomy is performed, and describing in detail the technique with which this group of evolutionarily authors came to accomplish the task.
- ItemSomente MetadadadosTratamento de malformação arteriovenosa pediátrica(Universidade Federal de São Paulo (UNIFESP), 2016-08-31) Paz, Daniel de Araujo [UNIFESP]; Chaddad Neto, Feres Eduardo Aparecido Chaddad Neto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)This study aims to conduct a comprehensive review of the literature and to assess the cases of pediatric AVM treated at UNIFESP group of Vascular Neurosurgery. A retrospective study was performed with analysis of patients with cerebral AVM diagnosis, aged 0 to 18 years, undergoing treatment by the team of Vascular Neurosurgery of the Federal University of São Paulo (UNIFESP). Patients were divided into two groups: surgical and radiosurgical. Analyzed data comprehended obliteration rate, neurological complications and morbidity rate in the presentation and after treatment. Thirty-seven patients were treated, 17 patients in the surgical group and 20 patients of radiosurgical group. It was observed that patients underwent surgical treatment presented an obliteration rate of AVM of 100%, scoring Good (100% between 0 and 2) in the modified Rankin scale (MRS) 3 months after treatment. On the other side, patients undergone radiosurgery showed obliteration rate of AVM of 26.3% in 3 years and 50% in 5 years, also scoring Good in mRS (between 0 and 95% 2) 3 months after treatment. The results indicated that the decisive parameter for the choice of therapeutic method, either alone or combined, was the location of the AVM. Morbidity in 3 months was mainly determined by the score in MRS scale immediately before the procedure. AVMs in eloquent areas were more difficult to treat and showed lower obliteration rate.