ABSTRACT
NeuRobot, a micromanipulator system with a rigid neuroendoscope and three micromanipulators, was developed for less invasive and telecontrolled neurosurgery. This system can be used to perform sophisticated surgical procedures through a small, 10-mm-diameter, window. The present study was performed to evaluate the feasibility of using NeuRobot in neuroendoscopy. Four different intraventricular neurosurgical procedures were simulated in three fixed cadaver heads using NeuRobot: (1) fenestration of the floor of the third ventricle; (2) fenestration of the septum pellucidum; (3) biopsy of the thalamus; and (4) biopsy of the choroid plexus of the lateral ventricle. Each procedure required less than 2 min, and all procedures were performed accurately. After these surgical simulations, a third ventriculostomy was carried out safely and adequately in a patient with obstructive hydrocephalus due to a midbrain venous angioma. Our results confirmed that NeuRobot is applicable to lesions in which conventional endoscopic neurosurgery is indicated. Furthermore, NeuRobot can perform more complex surgical procedures than a conventional neuroendoscope because of its maneuverability and stability. NeuRobot will become a useful neurosurgical tool for dealing with lesions that are difficult to treat by conventional neuroendoscopic surgery.
Subject(s)
Endoscopy/instrumentation , Micromanipulation/instrumentation , Neurosurgical Procedures/instrumentation , Biopsy/methods , Cadaver , Central Nervous System Venous Angioma/complications , Choroid Plexus/pathology , Endoscopy/methods , Humans , Hydrocephalus/etiology , Hydrocephalus/surgery , Magnetic Resonance Imaging , Male , Middle Aged , Neuroendoscopy , Neurosurgical Procedures/methods , Robotics , Septum of Brain/surgery , Thalamus/pathology , Tomography, X-Ray Computed , Ventriculostomy/instrumentation , Ventriculostomy/methodsABSTRACT
The aim of home care is to improve the quality of life (QOL) of terminal cancer patients in their own homes. Home care includes: 1) medical and nursing services available 24 hr a day; 2) activation of social resources for the support of the patient user, and his or her family; and 3) constructive cooperation with related institutions. Home care can result in expanded activities of daily living by relieving the patient's anxiety, controlling his or her pain, and preventing bedsores. It also serves to decrease the anxiety of the family and helps produce feelings of satisfaction regarding care. Home visiting nurse have played a pivotal role in certain cases by coordinating and gaining cooperation between the supply of the required social resources and the institutions related to this, for the terminal cancer patient at home. Nurses can accurately plan for care suited to the individual terminal cancer home patient and provide the proper environment for treatment. As a result, they are able to improve the user's QOL. They also function effectively as a go-between in conferences among persons, including family, related to setting up a place in the home for terminal care.
