FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to neurosurgery, and can be used for contralateral endoscopic clipping of ophthalmic aneurysms of the internal carotid artery. Burr-hole access is executed, including execution of a skin incision along the eyebrow line or along the natural crease of the upper eyelid, dissection of soft tissues, skeletisation of the underlying bone from the key point to the supraorbital incision, establishment of a hole in the key point, execution of supraorbital burr-hole craniotomy of 1.5 × 2 cm or orbitofrontal burr-hole craniotomy of 1.5 × 2 cm using a craniotome, opening of the dura mater with the size of the opening not exceeding 1.5 cm. The basal tanks are therein accessed subfrontally. After visualisation of the aneurysm, a 0° or 30° endoscope is inserted into the formed trepanation window. The endoscope is fixed on a pneumatic holder. The aneurysm is clipped with a vascular clip under endoscopic control. After the aneurysm is clipped, the endoscope is removed.
EFFECT: method provides leveling of the disadvantages associated with mini-accesses in the form of limited lighting and freedom in operation using micro-tools, eliminates ischemic damage to the visual apparatus and pituitary gland, reduces the risk of complications due to the use of endoscopic control and limited dissection, as well as focused opening of the basal cisterns and formation of a route to the contralaterally located aneurysm.
1 cl, 3 dwg, 1 ex
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Authors
Dates
2021-10-13—Published
2020-11-03—Filed