A set of coaxial microneurosurgical instruments.

Abstract

In an effort to lessen surgical trauma, neurosurgeons are developing more contained approaches requiring minimal or no brain retraction. The mobility of traditional microsurgical tools within such narrow corridors is severely restricted. A substantial portion of the surgical field may be obscured by the relatively large size of these instruments. To overcome some of these problems, the author has designed a set of new, low-profile, coaxial microinstruments. The coaxial shaft of these instruments is obtained by coupling a tube and a rod, rotating in opposite directions along their major axis. The rotational movement is delivered by compressing and releasing a spring-loaded, bayonet-shaped handle. The tips are obtained by flanging the two elements of the shaft. The initial set includes microscissors and microforceps, as well as tumor-grasping forceps. The two elements of the shaft can be disengaged easily by releasing a catch at the end of the shaft and disassembled for cleaning and basic maintenance purposes. The design of the present set of instruments combines a low-profile coaxial shaft with well-established ergonomic features, such as a pencil grip handle and an angled bayonet. The use of the least possible number of moving components enhances the reliability of these tools. The different profiles and angles of the tips partially compensate for the absence of a rotatable shaft, a potential shortcoming of these instruments.