Soft Micro-Balloon Paddy for Brain Retraction in the Protection of Neuronal Tissue

Abstract

Brain protection is extremely important during arachnoidal dissection and brain separation with a metallic retractor to create a surgical corridor. We have designed a new type of paddy containing air-filled micro-balloons and cotton for use between the metallic retractor and the brain surface for maximal protection of the neuronal tissues from the pressure of the retractor. In neurosurgical operations, cotton paddies are commonly and generally used during the retraction of brain tissue. We hypothesized that air-filled micro-balloon paddies covered with cotton could be helpful in the gentle separation of brain tissue with metallic retractors for minimizing cerebral damage, and for separating sulcal and cisternal walls during brain operations. These paddies are 2 cm in width and 4 cm in length. Multiple air-filled silicon micro-balloons are located in a sheet with 1-2 mm separation from each other. These silicon micro-balloonoid sheets are covered with a cotton sheath. The thickness of this type of paddy is 2-3 mm from the anterior surface to the posterior surface. We used paddies in 86 brain operations where brain retraction was necessary to create a surgical corridor. There was no complication or unwanted events related with the use of these paddies. In conclusion: air-filled silicon micro-balloon paddies are useful materials for the gentle separation of brain tissue with a metallic retractor in order to minimize cerebral damage, and for the separation of sulcal and cisternal walls during the surgical intervention.

Brain tumor - paddy - air-filled micro-balloon paddies - cotton paddy

References

• 1 Cokluk C, Aydin K, Senel A, Iyigun O. Transparent microballoon dissection in the surgical treatment of brain tumours.  Minim Invas Neurosurg. 2004;  47 127-129
• 2 Shahbabian S, Keller JT, Gould III HJ. et al . A new technique for making cortical incisions with minimal damage to cerebral tissue.  Surg Neurol. 1983;  20 310-312
• 3 Hirsch JF, Sainte-Rose C. A new surgical approach to subcortical lesions: balloon inflation and cortical gluing. Technical note.  J Neurosurg. 1991;  74 1014-1017
• 4 Abraham RG, Shyam Kumar NK, Chacko AG. A minimally invasive approach to deep-seated brain lesions using balloon dilatation and ultrasound guidance.  Minim Invas Neurosurg. 2003;  46 138-141
• 5 Madrazo I, Franco-Bourland R, Aguilera M, Reyes P, Guizar-Sahagun G. Balloon needle for the atraumatic transcortical ventricular approach: technical note.  Surg Neurol. 1990;  33 226-227

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