A set of coaxial microneurosurgical instruments.

OBJECTIVE: 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. DESCRIPTION OF INSTRUMENTATION: 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. DISCUSSION: 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. CONCLUSION: 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.