A new device with pressure regulation for microsurgical suction: technical note
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
References (9)
- et al.
Universal control suction valve
Surg. Neurol.
(1978) Alteration of suction tip pressure
J. Neurosurg.
(1977)Footpiece for suction control. Technical note
J. Neurosurg.
(1967)A microsucker for use in neurosurgery. Technical note
J. Neurosurg.
(1983)
Cited by (3)
A new suction instrument for spinal surgery
2011, World NeurosurgeryCitation Excerpt :additionally, it can hold the ligamentum flavum to allow better separation from the underlying dura mater. A literature search regarding the use of suction tools in spinal surgery showed several devices with additional functions with different proposals, such as the nerve root retractor (18) with a small posterior platform adjacent to the sucker tip to hold the dura mater; a reversible dissector (4) forming a 90° angle with the tip of the sucker that was conceived for brain surgery; a sucker with side apertures covered by film halves with the purpose of causing less damage to the tissues (11); a tubular portion slidably positioned over said suction tube and wherein the spatula is curved radially away from the suction tube with 1 cm for retracting the nerve root (12); a suction tube with a series of small holes on its proximal end allowing precise control of suction pressure during a microsurgical procedure (7). Our newly developed device clearly differs from the previously available ones and has more applications in the field of spine surgery.
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