Fig 5 - uploaded by Tetsuya Goto
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(a) Axial CT scan showing hydrocephalus; (b) axial T1-weighted MRI with contrast showing aqueductal stenosis and venous angioma in the midbrain; and (c) postoperative CT scan showing no hemorrhage with the ventricle size unchanged. Photographs of the third ventriculostomy: (d) the operating theatre with NeuRobot set through the patient's right frontal burr hole; and (e) intraoperative endoscope image showing fenestration of the floor of the third ventricle with the tear-open procedure.
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Context 1
... 41-year-old man suffering from dysuria and gait disturbance was referred to our service. Radiological examinations revealed obstructive hydrocephalus due to aqueductal stenosis caused by venous angioma in the midbrain (Fig. 5a, b). Third ventriculostomy was indicated. Prior to surgery, clinical application of NeuRobot had been approved by the Ethical Committee of Shinshu University School of Medicine, and informed consent was obtained from the patient and his family. The setup and the process of the operation were simulated in the operating room the day prior to ...
Context 2
... position under general anesthesia, and a 20-mm-diameter burr hole was made in the right frontal bone. A guide sheath was inserted into the right lateral ven- tricle. The sterilized slave manipulator was installed into the draped supporting device, and was introduced into the operative field with the insertion cylinder through the guide sheath (Fig. 5d). The microforceps were set in the micromanipulator. The insertion cylinder was positioned at the right lateral ventricle. As the foramen of Monro was 8 mm in diameter, the insertion cyl- inder was not advanced to the third ventricle. The microforceps were extended into the third ventricle, and the thin floor of the third ventricle was ...
Context 3
... ventricle. The microforceps were extended into the third ventricle, and the thin floor of the third ventricle was fenestrated by the same procedures as used in the cadaveric simulation; the fenestrated floor was held by two pairs of microforceps and the hole was widened to 5 mm in diameter by rotation of the microforceps in the micromanipulator (Fig. 5e). The basilar artery and its perforating arteries were visible beneath the hole, and the third ventriculostomy was achieved without touching them. The patient's postoperative course was uneventful. No signs of infection or other complications related to usage of the system were encountered. His neurological symp- toms recovered ...
Context 4
... was achieved without touching them. The patient's postoperative course was uneventful. No signs of infection or other complications related to usage of the system were encountered. His neurological symp- toms recovered gradually after the operation, although the ventri- cle size did not decrease after surgery, as determined by CT scan (Fig. ...
