Difference between revisions of "Surgical Procedure"
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|[[File:Fig07.jpg|400px]] || At the bottom of burr hole, there is a very thin bone flap left. Remove the flap carefully with curette. | |[[File:Fig07.jpg|400px]] || At the bottom of burr hole, there is a very thin bone flap left. Remove the flap carefully with curette. | ||
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− | |[[File:Fig08.jpg|400px]] || | + | |[[File:Fig08.jpg|400px]] || Confirm no bone flap is left and dura is fully exposed in burr hole. Gently peel off dura from skull and make epidural space around burr hole. This has to be done in all burr hole. |
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− | |[[File:Fig09.jpg|400px]] || | + | |[[File:Fig09.jpg|400px]] || Epidural spaces between burr holes are connected. This tunnel will be a working space for Craniotome. Make sure all of epidural spaces underneath lines of bone incision are connected. |
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− | |[[File:Fig10.jpg|400px]] || | + | |[[File:Fig10.jpg|400px]] || Craniotome is cutting bone on the line. It starts from one hole to the next hole. At the hole where Craniotome is heading, suction tube is pushing dura down to make sufficient working space. Assistant is dropping saline at the cutting edge. |
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− | |[[File:Fig11.jpg|400px]] || | + | |[[File:Fig11.jpg|400px]] || Craniotome successfully cut the bone all the way around. At this point, the bone piece is still attached to dura at the center. |
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− | |[[File:Fig12.jpg|400px]] || | + | |[[File:Fig12.jpg|400px]] || Removing the bone piece. The piece has to be lifted up gently from one edge and peel off dura from the piece with spurtle. This process has to be done slowly and carefully. Otherwise, it will tear dura easily. |
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− | |[[File:Fig13.jpg|400px]] || | + | |[[File:Fig13.jpg|400px]] || Now dura is exposed. Wash the area and remove bone tips and stop bleeding if there is. Before cutting dura, put two traction sutures with silk. The needle should not penetrate dura but scoop it at 2/3 depth of dura's thickness. |
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|[[File:Fig14.jpg|400px]] || (figure 14) | |[[File:Fig14.jpg|400px]] || (figure 14) |
Revision as of 07:38, 14 August 2011
Surgical illustrations courtesy of [Juna Kurihara]