安全で正確な脳動脈瘤クリッピングのための手術解剖の確認と正常構造の温存─無血術野の獲得と強拡大下操作─

概要

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The skills of skull-base drilling and cerebral revascularization are now essential in open surgery for cerebral aneurysms. For this purpose, achieving a bloodless operative field, and identifying and preserving the normal anatomical structures are imperative. We propose the effectiveness of creating a bloodless operative field and operating under a high magnetic field by presenting four common approaches for aneurysm surgery: the transsylvian approach; interhemispheric approach; extradural anterior clinoidectomy; and lateral suboccipital approach. Here we show how we achieve our preferred operative field and present our operative figures. For safe, high-quality clipping of cerebral aneurysms, vascular surgeons should create a bloodless operative field, adjust to surgery under a high magnetic field and train hard for skull-base drilling by attending cadaver courses.
一般社団法人日本脳卒中の外科学会の論文