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Removal of right cerebellar arterovenous malformation with 3D - 4K digital exoscope
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Every surgical treatment of AVMs requires a dedicated planning that covers several areas of neurosurgery. This video will describe a multimodal approach that integrates neuroradiology, neurosurgery and neurophysiology to a complex vascular case. Other than describing a very rare case, in this video it is possible to better understand the surgical strategy for the treatment of a complex AVM.
Finally, this video will show how exoscope can be of use in the treatment of complex vascular cases allowing different kind of views of the surgical field.
Introduction
This video enables the viewers to better understand the surgical strategy to be adopted for the treatment of a complex AVM.
About The Authors
Prof. Carlo Giussani currently is the Director of the Neurosurgical Division of the San Gerardo Hospital, Monza, Italy, whose clinical activity focuses on the diagnosis and treatment of the main cranial and spinal neurosurgical pathologies of both adult and paediatric age. Associate Professor of Neurosurgery and Vice Chairman at the Milano-Bicocca University since 2015, were he is the Director of the neurosurgical training programme. Prof. Giussani also holds the position of Associate Professor of Neurological Surgery at the Department of Neurological Surgery.
Dr. Andrea Di Cristofori , obtained a PhD in Clinical Neuroscience from the Bicocca University in Milan, and currently works at the Neurosurgical Division of the San Gerardo Hospital, Monza, in Prof. Giussani’s team.
About this video
- Author(s)
- Carlo Giussani
- Andrea Di Cristofori
- DOI
- https://doi.org/10.1007/978-3-031-37715-0
- Online ISBN
- 978-3-031-37715-0
- Total duration
- 36 min
- Publisher
- Springer, Cham
- Copyright information
- © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2023
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Video Transcript
[MUSIC PLAYING]
Good morning, everybody. My name is Carlo Giussani. I’m the Chief of Neurosurgery at the Ospedale San Gerardo dei Tintori, Monza, IRCC Foundation. And I am a full Professor of Neurosurgery at University of Milano-Bicocca School of Medicine.
An AVM is an Arterial Arteriovenous Malformation, which is a chaotic malformation– vascular malformation– which presents the abolition of the capillary field, between the arterial and the venous compartments, and can grow wherever in the central nervous system. We are going to show this case of an AVM, that is located in the right, inferior, cerebellar peduncle and the right tonsil, to demonstrate how it is possible to manage a very complex AVM in a very complex anatomical area, like the brain stem, where cerebellar structures– the cranial nerves and, of course, all the inferior vascular structure of the posterior circulation in a combined fashion.
It is the preoperative embolization that is followed by an immediate surgical resection, that is, again, followed by an angiographic control of resection. We can show how it is possible to perform this kind of surgery with the use of an exoscopic technique that can permit a great magnification of a field for angiographic images and virtually an infinite number of angles of attack of AVM.
This video is devoted to that surgeons that are practically currently the microvascular surgery and we want to focus with this colleague on the fact that it is possible to manage, in elective fashion, these complex cases with the use of embolization, and microsurgery, and exoscope. Thank you very much.