Journal
NEUROSURGERY
Volume 65, Issue 4, Pages 826-827Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1227/01.NEU.0000350985.58062.3F
Keywords
Balanced irrigation-suction technique; Intracerebral hemorrhage; Minimally invasive surgery; Multifunctional suction cannula; Neuroendoscopy
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OBJECTIVE: Endoscopic evacuation of intraoperative hemorrhage is proving to be increasingly useful and effective. For general agreement that endoscopic evacuation has advantages over craniotomy, secure hemostatic procedures are crucial. TECHNIQUE: This technical note focuses on hemostatic procedures for managing intraoperative hemorrhage. Handling of the multifunctional suction cannula and its application for balanced irrigation-suction are fully explained in this report. RESULTS: Nearly complete evacuation of hematoma was achieved in all 15 cases. In 9 cases of intraoperative arterial bleeding, secure hemostatis has been accomplished. No surgical complications or rebleeding occurred. CONCLUSION: Even careful atraumatic evacuation of a hematoma can sometimes result in intraoperative hemorrhage. Repeated irrigation and point suctioning may be necessary to keep the operating field clear. A multifunctional suction cannula would be useful for maintaining irrigation and suction balance. Coagulation of a bleeding artery can be performed under clear visualization. A balanced irrigation-suction technique results in secure hemostasis.
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