Elsevier

Surgical Neurology

Volume 63, Supplement 1, January 2005, Pages S36-S38
Surgical Neurology

A new device with pressure regulation for microsurgical suction: technical note

https://doi.org/10.1016/j.surneu.2004.09.014Get rights and content

Abstract

A new suction tube that allows precise control of suction pressure during microsurgical procedures is described. The new device consists of a suction tube that has a series of small holes on its proximal end. These holes can be progressively opened or closed by a laterally placed sliding bar. The surgeon can readily adjust the suction pressure by slightly moving his thumb up and down with accordance to his convenience during the operation. This creates an easy and prompt way to regulate suction pressure, thus removing the need of suction adjustment by the assistant or the scrub nurse. This new device provides an easy, precise, and quick suction regulation during the different stages of the microsurgical procedure. When the holes are totally closed, a maximum suction pressure is achieved, and when the holes are fully opened the suction pressure can be brought to zero. This device is very simple and ergonomic and allows an adjustable suction pressure mechanism that is regulated by the surgeon. By smoothly using the thumb to move the sliding bar up and down, the suction pressure may vary within the range of a maximum to zero almost instantaneously providing the appropriate suction pressure at any surgical time.

Introduction

The suction device was introduced to the medical field in 1869 by Dielafoy, a French surgeon [6]. The suction tube is a multipurpose device that is used in neurosurgery as a sucker, a microdissector, and as a dynamic retractor. It is a key surgical tool that allows for a clean and dry surgical field, especially when working under the operating microscope and navigating close to important anatomical structures.

Different suction pressures are required during different surgical steps. To be effective, the suction tube should be light-weighted and comfortable to handle. The suction tip must have an appropriate size, length, and caliber to best suit each particular operation. The suction pressure should be precisely regulated to avoid damage to the brain, the cranial nerves, and the vessels of the brain. At the same time, the suction system should provide a clean surgical field. Low suction pressure is usually required during arachnoid dissection, dissection of neurovascular structures, tumors, and aneurysms. In such instances the suction tube is mainly used as a dynamic retractor and as a microdissector. High suction pressure is usually required in the event of intraoperative hemorrhage, for the removal of soft tumors, and for resection of neural tissue in selected cases. Fast and fine changes in suction pressure may be required during surgery. Ideally, the surgeon should be able to adjust the suction pressure easily and in a timely fashion according to the surgical situation.

A new and simple mechanism to control the suction pressure is described along with a new suction tube.

Section snippets

Materials and methods

The proposed suction tube consists of a fixed cylindrical metal handle with small holes located on the lateral aspect of its proximal end. A conventional distal shaft, which is a hollow tube, extends from the distal part of the handle. The handle closely resembles the shape of a pencil.

The tube is made of steel and is 180 mm long, with a flattened lateral part to which the sliding metal bar connects (Fig. 1). The sliding metal bar runs up and down in relation to the lateral flattened surface of

Discussion

Suction means vacuum created by lowering the air pressure at one side of a closed tube or system. The negative pressure in the suction system is produced by an air pump that creates vacuum and consequently suction. The balance between the entrance and exit of air in the suction system determines the suction pressure. A closed system provides for maximum suction pressures because all the vacuum is transmitted to the suction tip, as when the holes of our proposed device are fully closed. On the

Conclusions

The device presented is very simple and ergonomic. It has the advantage of allowing the surgeon to alter the suction force quickly and easily and to hold the instrument for fine hand movements. By smoothly using the thumb to move the sliding bar up and down, the suction pressure may vary within the range of a maximum to zero almost instantaneously providing the appropriate suction pressure at any surgical time. With little practice, the surgeon will quickly develop the ability to rapidly and

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