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Minimally Invasive Neurosurgery (MIS)

Minimally Invasive Neurosurgical (MIS) techniques offer neurosurgeons a great improvement in working conditions to achieve effective neurosurgery and an improved outcome for patient conditions including:

Minimally Invasive Neurosurgery (MIS) is not just the sole use of a microscope during a conventional neurosurgical exploration. It is an entirely new surgical discipline and concept requiring the use of a mobile counter-balanced operating microscope, and necessitating mastery of indirect eye-hand interaction which can only be acquired in a specially equipped laboratory.

microsurgery
surgeons


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Minimally Invasive Surgery (MIS) has two main components:

1. Special equipment:

  • Counter-balanced mobile operating microscope equipped with T.V. camera and monitors to enhance and promote team work in the operating room between surgeon, neuroanesthesiologist, nurses, and technicians.
  • Bipolar coagulators and bipolar forceps of different lengths and tip size. Also “Isocool” (J&J product) bipolar tips that need minimal cleaning due to patented internal thermodynamic countercurrent cooling mechanism.
  • Pressure regulated suction apparatus and suction tubes in different lengths and diameters.
  • Bayonet-shaped surgical instruments in different lengths and tip sizes and malleable microinstruments.
  • Microsutures and special needle holders.
  • Self-retaining "protective" brain retractors.
  • Hydraulic chair and adjustable arm rest for the surgeon.
  • Magnified Loupes (glasses for general Neurosurgery, peripheral nerve surgery and spinal surgery outside the dura (spinal cord and root covering). Also used with a headlight for optimal lighting.
Loupes
Loupe

2. Special surgical techniques requiring laboratory training:

  • Enhanced eye-hand interaction working under conditions of indirect vision with the operating microscope.
  • Delicate manipulation with microinstruments during dissection, clipping, coagulating, neurovascular repair, and grafting.
  • Tactics to operating within a key-hole approach performing the procedures as mentioned above; but, under more difficult conditions, for example plastic boxes of different heights (5-12 cm) and with narrow openings cm diameter) simulate deep narrow approaches within and around the brain. RACS workshops and accredited Microneurosurgical courses. Also Da Vinci robotic surgical techniques used in Urology.
  • Delicate and controlled manipulations within the confines of a small gap and using a self-retaining protective brain retractor.
  • Training the use and applications of the bipolar coagulator and microsuction equipment.
  • Training to develop expertise and comfort using high-speed surgical drills. i.e. Midas Rex (Medtronic) drill workshops accredited world-wide.

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