{"title":"[Surgical Simulation Using a Three-Dimensional Printer].","authors":"Yuki Sakaeyama, Nobuo Sugo","doi":"10.11477/mf.1436204909","DOIUrl":"10.11477/mf.1436204909","url":null,"abstract":"<p><p>3D printers have been applied in bone-based surgeries, including craniofacial, plastic, oral, and orthopedic surgeries. The improved capabilities of diagnostic imaging equipment and 3D printers have enabled the development of more precise models, and research on surgical simulations and training in the field of neurosurgery is increasing. This review outlines the use of 3D printers in neurosurgery at our institution in terms of modeling methods and surgical simulations. Modeling with the powder-sticking lamination method using plaster as the material allows drilling, which is a surgical procedure. Therefore, it is useful for simulating skull base tumors, such as petrosectomy in a combined transpetrosal approach or anterior clinoidectomy in an orbitozygomatic approach. The color coding of each part of the model facilitates anatomical understanding, and meshed tumor modeling allows deep translucency. As shown above, the 3D printer's modeling ingenuity allows for useful surgical simulations for each case.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"254-262"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Various Bypass Surgery:Preoperative Simulation for STA-MCA Bypass].","authors":"Hiromasa Kobayashi, Yoko Matsuo, Atsushi Hirota, Ken Miyagawa, Ryota Taomoto, Takayuki Koga, Hiroshi Abe","doi":"10.11477/mf.1436204924","DOIUrl":"10.11477/mf.1436204924","url":null,"abstract":"<p><p>In STA-MCA bypass surgery, it is important to select the optimal recipient using preoperative simulation to avoid complications. We report a preoperative simulation for STA-MCA bypass using the Brain LAB iPLAN platform<sup>®</sup>BRAIN LAB)and the 3DCG simulation software GRID<sup>®</sup>Kompath). Here, we introduce the basics and applications of preoperative simulation for occlusive atherosclerotic lesions and present a target bypass for periventricular anastomosis and peripheral vessels of aneurysms in Moyamoya disease. By creating and visualizing 3D fusion images, the optimal donor and recipient can be selected. Determining the skin incision and extent of craniotomy according to the case is also applicable to the minimally invasive STA-MCA bypass. Preoperative simulations enable accurate pinpoint bypass surgery and prevent complications.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"389-398"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Carotid Artery Stenting].","authors":"Daizo Ishii, Nobutaka Horie","doi":"10.11477/mf.1436204925","DOIUrl":"10.11477/mf.1436204925","url":null,"abstract":"<p><p>Currently, stricter indications for carotid artery stenosis are required owing to improvements in multifaceted medical treatment, including the intensive management of risk factors for atherosclerosis and lifestyle changes. High-risk factors for carotid artery stenting, such as vulnerable plaques, severe calcification, pseudo-occlusion, and difficult access, should be evaluated before endovascular intervention. Therefore, we need to understand the characteristics of each device to achieve maximum risk reduction for carotid artery stenting.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"399-406"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Craniotomy Clipping for Cerebral Aneurysms].","authors":"Hiroki Uchida, Hidenori Endo","doi":"10.11477/mf.1436204922","DOIUrl":"10.11477/mf.1436204922","url":null,"abstract":"<p><p>Preoperative simulation is essential to safely complete neurosurgical procedures. A vascular-oriented approach is important in cerebrovascular disorder surgery, considering anatomical variations among individuals. Particularly, subarachnoid hemorrhage surgery requires a detailed simulation of a safe dissection procedure, considering the rupture point of the aneurysm, and combined computed tomography or magnetic resonance imaging images with cerebral angiography can be useful. We present a case of subarachnoid hemorrhage and introduce the preoperative simulation performed at our hospital.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"374-379"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Brain Stem and Para-Brain Stem Lesions].","authors":"Soichi Oya, Syunya Hanakita","doi":"10.11477/mf.1436204921","DOIUrl":"10.11477/mf.1436204921","url":null,"abstract":"<p><p>Surgeries for brainstem lesions and adjacent areas needs meticulous manipulation in the profoundly deep surgical field. Moreover, it is associated with a high risk of complications pertinent to resection. The opportunity for a surgeon to amass extensive surgical experience in these lesions is limited. Additionally, the reduced tissue mobility in the brainstem, compared to other lesions, makes selecting the optimal surgical approach critical. Preoperative simulation is pivotal in surmounting these challenges. However, the limitations of preoperative simulations should be recognized in accurately depicting diminutive vessels and cranial nerves around the brainstem. Incorporating intraoperative anatomical observations and data from intraoperative monitoring into a surgical strategy is imperative. Here, we present three cases in which we believe preoperative simulation was effective; a cavernous hemangioma of the brainstem, trochlear schwannoma, and diffuse midline glioma in the pons.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"367-373"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Interactive Virtual Simulation with Haptics for Neurosurgery].","authors":"Makoto Oishi, Ryosuke Ogura","doi":"10.11477/mf.1436204912","DOIUrl":"10.11477/mf.1436204912","url":null,"abstract":"<p><p>We established a unique pre-surgical simulation method by applying interactive virtual simulation(IVS)using multi-fusion three-dimensional imaging data, presenting high-quality visualization of microsurgical anatomies. Our IVS provided a realistic environment for imitating surgical manipulations, such as dissecting bones, retracting brain tissues, and removing tumors, with tactile and kinesthetic sensations delivered through a specific haptic device. The great advantage of our IVS was in deciding the most appropriate craniotomy and bone resection to create the optimal surgical window and obtain the best working space with a thorough understanding of the lesion-bone relationship. Particularly for skull-base tumors, tailoring the procedures to individual patients for craniotomy and bone resection was sufficiently achieved using our IVS. In cases of large skull base meningiomas, our IVS was also helpful preoperatively regarding tumors, as several compartments were achievable in every potentially usable surgical direction. Additionally, the non-risky realistic microsurgical environments of the IVS provided improvement in the microsurgical senses and skills of young trainees through the repetition of surgical tasks. Finally, our presurgical IVS simulation method provided a realistic environment for practicing microsurgical procedures virtually and enabled us to ascertain the complex microsurgical anatomy, determine optimal surgical strategies, and efficiently educate neurosurgical trainees.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"279-288"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Japanese National Plan for Promotion of Measures against Stroke and Cardiovascular Diseases and Data-Based Health Management Initiatives].","authors":"Koji Iihara","doi":"10.11477/mf.1436204930","DOIUrl":"10.11477/mf.1436204930","url":null,"abstract":"<p><p>This review outlines the recent advances in stroke and cardiovascular diseases control and direction of national data health reform. Since the enactment of the Basic Act on Countermeasures against Cardiovascular Diseases, the national government and related academic societies have collaborated to promote countermeasures based on five key pillars; medical systems development, registration projects promotion, human resource development, public awareness, and research promotion. Simultaneously, the government is intensively promoting data health reform to compensate for the delay in digital medicine that became evident in the new coronary infection. Data health reform has four major pillars; promotion of using genomic medicine and artificial intelligence(AI), promotion of personal health records(PHR), promotion of information utilization in medical and nursing care settings, and promotion of effective database utilization. Five years have passed since the Basic Act on Countermeasures for Cardiovascular Diseases was enacted, and it is important that the Japanese Stroke Association, Japanese Cardiovascular Society and other related academic societies, government, prefectures, and National Cardiovascular Center collaborate to vigorously promote the cardiovascular disease countermeasures.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"433-447"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Presurgical Simulation for Brain Arteriovenous Malformation].","authors":"Jun C Takahashi","doi":"10.11477/mf.1436204923","DOIUrl":"10.11477/mf.1436204923","url":null,"abstract":"<p><p>Surgical extirpation of brain arteriovenous malformations(AVMs)requires precise pre-surgical simulation. Utilizing image software, widely used with picture archiving and communication systems(PACS), surgeons can generate simulation images that precisely illustrate the proper feeders, passing arteries, and drainers. The crucial steps for creating informative simulation images include: (1)the free rotation of reconstructed 3D digital subtraction angiography(DSA)images; (2)removal of irrelevant arteries(the most important procedure); and(3)construction of stereo imagery of the \"core images.\" This article presents a detailed description of these procedures.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"380-388"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Thrombectomy].","authors":"Daizo Ishii, Nobutaka Horie","doi":"10.11477/mf.1436204926","DOIUrl":"10.11477/mf.1436204926","url":null,"abstract":"<p><p>Endovascular procedures have become the standard treatment for acute stroke caused by large vessel occlusion. Various strategies are available, including stent retrieval, aspiration catheter placement, and combined techniques. However, the first-pass effect can be maximized using the technique most familiar to each surgeon and institution. Therefore, it is necessary to understand the characteristics of each device and develop case-specific treatment strategies.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"407-414"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[New Preoperative Simulations for the Future of Hydrocephalus Surgery].","authors":"Shigeki Yamada","doi":"10.11477/mf.1436204913","DOIUrl":"10.11477/mf.1436204913","url":null,"abstract":"<p><p>Ventricular puncture is a basic procedure that neurosurgeons learn in the early stages of their careers and is also performed in ventricular drainage and neuroendoscopic surgery. However, few neurosurgeons are confident in their ability to insert and place a ventricular catheter in the optimal position for ventriculoperitoneal(VP)shunting in a single pass. Even experienced neurosurgical consultants confident in difficult microsurgical procedures are uncomfortable with ventricular catheter placement in VP shunting. Moreover, many neurosurgeons believe that they will never perform a ventricular puncture from the posterior horn of the lateral ventricles. The reason for thinking that ventricular puncture via the anterior horn is safer and more accurate compared with the posterior approach is because the anterior approach can use facial landmarks such as eyes, nose, and ears. However, even with the anterior approach in VP shunting, it is more difficult than with ventricular drainage or neuroendoscopic surgery to achieve accurate placement owing to head rotation, and the success rate has been reported to be as high as 50%. In this article, I introduced \"fool proof,\" which uses preoperative simulation to place a ventricular catheter in the optimal position according to the size and shape of each patient's head and ventricles. The first choice for VP shunting is the right parieto-occipital approach with a posterior horn puncture from Frazier's Point and, for L-P shunting, a paramedian puncture from the 2/3 or 3/4 lumbar interspace.</p>","PeriodicalId":35984,"journal":{"name":"Neurological Surgery","volume":"52 2","pages":"289-298"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}