Minimally invasive bedside craniotomy using a self-controlling pre-adjustable mechanical twist drill trephine

Area of Science:

• Neurosurgery
• Minimally Invasive Procedures
• Medical Device Innovation

Background:

• Craniotomy using a mechanical twist drill is standard for chronic subdural hematoma drainage and ventricular drain placement.
• Standard twist drill trephines pose a risk of causing cerebral lesions due to uncontrolled penetration.

Purpose of the Study:

• To evaluate a modified mechanical twist drill designed to prevent cerebral lesions during craniotomy.
• To assess the safety and efficacy of the modified twist drill in neurosurgical procedures.

Main Methods:

• A mechanical twist drill system was modified with a self-controlling drill and adjustable distance holder to limit intracerebral penetration.
• The modified trephine underwent cadaver testing and was subsequently used in 65 patient trephinations for various neurosurgical conditions.

Main Results:

• The modified trephine successfully prevented cerebral lesions and complications associated with deep or uncontrolled drilling.
• No procedure-related infections occurred, and drilling time was significantly reduced in the patient series.

Conclusions:

• The modified mechanical twist drill provides a safe, fast, and easy method for craniotomy, retaining the benefits of mechanical drills.
• This device is particularly recommended for emergency neurosurgical conditions requiring rapid intervention.