Download - Ventriculocisternostomia Endoscopic ă
![Page 1: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/1.jpg)
VENTRICULOCISTERNOSTOMIA ENDOSCOPICĂ
Cristina Aldea
![Page 2: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/2.jpg)
ETV
Simplu și elegant
Folosit inițial ca și procedură de bypass al apeductului (pentru tratamentul hidrocefaliei obstrucitve) 1
1 Grant JA, McLone DG: Third ventriculostomy: a review. Surg Neurol 47:210–212, 1997
![Page 3: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/3.jpg)
Indicatii Actuale
SA primar Hidrocefalie izolata a ventriculului lateral Stenoza idiopatica a foramenelor Magendie si Luschka Malformatia Dandy-Walker Hidrocefalie secundara unui hematom IV Reducerea efectului de masa secundar unor tumori IV,
pineale, tectale, de fosa posterioara sau CA (pineala, cist. Cvadrigeminala)
„slit ventricle” sdr. Hidrocefalie cu presiune normala Hidrocefalie comunicanta …
![Page 4: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/4.jpg)
Tehnica operatorie
Inainte:
Pozitionarea pacientului!
Operator principal +/- 1 ajutor
Endoscop rigid
Pupilele pacientului
![Page 5: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/5.jpg)
Semi-sezanda, capul inclinat anterior!
![Page 6: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/6.jpg)
Punctul de acces.
![Page 7: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/7.jpg)
![Page 8: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/8.jpg)
Repere Anatomice
Vizualizate/recunoscute! perete inferior – translucid
NU electrocauter
ventriculi dilatati
![Page 9: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/9.jpg)
![Page 10: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/10.jpg)
![Page 11: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/11.jpg)
![Page 12: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/12.jpg)
![Page 13: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/13.jpg)
![Page 14: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/14.jpg)
![Page 15: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/15.jpg)
Riscuri. Complicatii Posibile
Patenta fenestratiei compromisa
Lezarea structurilor anatomice (accident intraoperator/neglijenta)
![Page 16: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/16.jpg)
Metode de a minimaliza riscurile procedurii
Anatomie!
![Page 17: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/17.jpg)
Avantaje.
Tehnica relativ facila
durata scurta a interventiei( cca. 30 minute)
![Page 18: Ventriculocisternostomia Endoscopic ă](https://reader035.vdocuments.pub/reader035/viewer/2022062720/5681358d550346895d9cf844/html5/thumbnails/18.jpg)