Short-Burst Bipolar Coagulation for Repairing Partially Damaged Brain Arteries Preserving Their Flow: Technical Note

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• 作者：Joham Choque-Velasquez¹ ; ^{johchove@hotmail.com" class="auth_mail" title="E-mail the corresponding author} ; Roberto Colasanti¹ ; ² ; Behnam Rezai Jahromi¹ ; Ahmadreza Rafei¹ ; Fransua Sharafeddin¹ ; Juha Hernesniemi¹
• 关键词：Bipolar coagulation ; High magnification ; Microneurosurgery ; Neurosurgical practice ; Surgical techniques ; Vascular repair
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：93
• 期：Complete
• 页码：324-329
• 全文大小：1407 K

文摘

Preservation of the integrity of perilesional and intralesional arteries, as well as of perforating vessels, is of utmost importance in microneurosurgery. The purpose of our study was to describe our adaptation of the short-burst bipolar coagulation technique, which was initially introduced by Professor Yasargil, for repairing partially damaged brain arteries.

Methods

When a brain artery is partially and inadvertently damaged during microneurosurgical procedures, microscope magnification is further increased from the high magnification that is routinely used (10–15×) up to 14–17× in order to recognize clearly the injured zone of the vessel. Then the exact bleeding point is identified with a precise suction. Next, bipolar forceps with sharp tips (0.3 mm) are used to seal the wall of the injured artery, closing the borders of the hole between them. A delicate coagulation (20 Malis units, 3 watts) is performed for less than a second according to the so-called “open-close” technique. Short and small bursts of coagulation are used to progressively reduce the size of the defect by cauterization of the surrounding tissue. This gradually diminishes the bleeding up to restore the functional integrity of the vessel wall.

Results

The senior author's modification of the Yasargil technique has been used for more than 30 years as a simple and fast method of microsurgical vascular repair of small tears.

Conclusions

The bipolar coagulation represents a safe, clean, fast, and even cheap method for repairing wall defects in fine arteries that are accidently damaged during a microsurgical operation.