[Electrosurgery, the cornerstone of current achievements of brain tumor surgery--on the occasion of 80th anniversary].
Neurosurgical pioneers had so many obstacles that prevented safe work and favorable outcome of the patients operated on. The mortality rate was high and discouraging. The operations were fast and rude whereafter the patients were dying or suffered prolonged hemorrhagic shock. The three cornerstones of neurosurgery, i. e. cerebral localization, asepsis and narcosis, had not yet been discovered and the only diagnostic tools available were recently discovered x-rays, ventriculography and angiography. However, the greatest challenge for the neurosurgeon was that even if luckily localized through a craniotomy, how to remove the brain tumor while avoiding uncontrollable bleeding. Therefore, an array of techniques and tricks were developed such as bone wax, Cushing silver clips, packing of the wound, etc. but all of them were insufficient in case of intracerebral hemostasis. Electrosurgery revolutionized this unacceptable situation thoroughly. It was introduced in neurosurgery 80 years ago (on October 1, 1926) by great Cushing, whereupon its usage has spread rapidly worldwide. The mortality rate was lowered to 13%! The coagulator was constructed by Harvard's physicist Bovie, after whom is named. Owing to the new technique, the control of bleeding in neurosurgery has become much safer, craniotomies are larger than before and the operation time is esentially longer. Since the perfection of bipolar coagulation (by Greenwood and Malis brothers), and after the introduction of the operating microscope (Donaghy, Krayenbühl, Yasargil) in 1970, this half of a century-long monopolar era was over, and the new time of microneurosurgery has begun. It enables better, easier and more precise hemostasis of the magnified brain blood vessels (microscope).
Tudor
Katarina Ivana
KI
Department of Neurosurgery, Split University Hospital Center, Split, Croatia.
Tudor
Mario
M
Buca
Ante
A
Cambi-Sapunar
Liana
L
Tudor
Lorainne
L
Dujmović
Davor
D
Carija
Robert
R
Sucević
Darijo
D
Carić
Drago
D
D001932:Brain Neoplasms / Q000266:history* / Q000601:surgery; D004598:Electrosurgery / Q000266:history*; D049669:History, 16th Century; D049673:History, 20th Century; D006801:Humans; D009493:Neurosurgery / Q000266:history; D019635:Neurosurgical Procedures / Q000266:history*