hsp-gu-190g-004 cirugia estereotaxica

8/2/2019 HSP-GU-190G-004 Cirugia Estereotaxica

1/7

^bvpkli1 5

@KVROKE BPTBVBLT EZK@EK @ldkul1 JP](OR(K 5;=O(==4

Jlp}ktec +((((((((((((((('(((((((5 E) keyy`kyPkh>i Flck~ev #))y)&7171#yw&JLP]KT ECkQE@KLI

IBRVL@KVROKE

TEFCE DB @LITBIKDL

5) ARPTKNK@E@KLI6) LFABTK^LP0 ) ]VLNBPKLIECBP E URKBIBP ^E DKVKOKDL4 ) ]LFCE@KLI DKEIE K BZ@B]@KLIBP2) HBTLDLCLOKE> ) E@TK^KDEDBP =]VL@BDKHKBITLP? ) ECOLVKTHL DB E@TRE@KLI: ) KIDK@EDLVBP DB B^ECRE@KLI; ) OCLPEVKL K DBNKIK@KLIBP5=) FKFCKLOVENKE55) VBOKPTVLP56)EIBZLP

BCEFLVL1

K NB@JE1K Bibvl db 6=56

]eokie 5 db ?


2/7

^bvpk>i1 5

KK @>dkol1 JP](OR(# 5;=O(==4KVROKE BPTBVBLT EZK@EJlp}ktec

Pkhli Flck~evJLP]KT ECkQE@KLI

IBRVL@KVROkE

5) ARPTKNK@E@KLI

Tbikbidl bi `rbite bc `vb`kbitb irvibvl db }e`kbitbp `li vbnve`tbvkbded ectvetehkbitl `li~bi`kliec fepedl bi hbdkèhbitlp }eve hl~khkbitlp eilvhecbp# [`vkpkp `li~rcpk~ep# `lhl teh fkbi bc tbibv urb vbplc~bv bc }vlfcbhe dkeoilptk`l dbcbpklibp `bvbfvecbp bi pktklp il ecèiqefcbp `li clp }vl`bdkhkbitlp urkvrvuk`lp`li~bi`kliecbp# pb vburkbvb rie orke db heibal }eve bptep pktre`klibp `cnikèp bibc pbv~k kl db Ibrvl`kvrone)6) LFABTK LP

Dev `litkirkded bi nlvhe kitbovec ec tvetehkbitl hbdk`l vburbvkdl }eve bptb tk}l db}e`kbitbp)0) ]VLNBPKLIECBP E URKBIBP Ê DKVKOKDLBp}b keckptep bi Ibrvl kvrone# Vbjefkckte k>i# Kitbipk~kptep# ]pkurketvep]pk`ltlulp# Ibrvlclulp prfbp}b`keckptep bi hl~khkbitlp eilvhecbp#Binbvhbvep Abnbp# erzkckevbp)Tvefeaedlvep Pl`kecbp)@ehkccbvlp)4) ]LFCE@KLI DKEIE K BZ@B]@KLIBP]e`kbitbp vbnve`tevklp# dbnkikdlp bi arite hbdc`lurkvrvokè kitbvdkp`k}ckievkebp}b`kec hbitb dbc tbvvbil prfbp}b`keckqedl bi hl~khkbitlp eilvhecbp)2) HBTLDLCLOKEE@TK^KDEDBP = ]VL@BDKHKBITLP

2)5 FKL]PKE BPTBVBLTE@TK@E1

Clp }e`kbitbp dbfbvei pbv vbhktkdlp dkvb`tehbitb e ce `liprcte bztbvie# èirie lvdbi db vbhkpk>i e plck`ktrd db fkl}pke bptbvbl te`tkè) )

Bi ce `liprcte pb vbeckqeve ce }vlovehe`k>i# nb`je { dne db jlp}kteckqe`kli) Bi ce `liprcte bztbvie pb bceflveve ce vbp}b`tk~e jkptlvke `ccikè# bzehbi

obibvec { ibrvlcluk`l# pb jeve bc eiec kpkp db clp bptrdklp db ceflvetlvkl bkheubilcluk`lp)

Clp èpep }vlfcbhe pbvei dkp`rtkdlp bi ce arite db db`kpklibp urkvrv}kèp

]eokie 6 db ?


3/7

@>dkol1 JP](OR(5;=O(==4KVROKE BPTBVBLTEZK@EE K) @E C) Dk E H E[ LVDBFLOLTED)) )

1( 7&/##(3)( /=y & & ) & / y y / 7 ) 9 ( k 7 93+ # / a3 9 K^HJlp}ktec

Pkhli Flck~ev K ^bvpkli1 5LP]KT ECkQE@KLIIBRVL@KVROKE

Clp }e`kbitbp jlp}kteckqedlp bi ltve kiptktr`k>i# dbfbi pbv `liprctedlp e ril dbclp bp}b`keckptep dbc pbv~k kl }eve ertlvkqev bc tvepcedl) ]eve e`b}tev pr tvepcedl dbfb bptev tldl dbfkdehbitb }vlovehedl { dkp}likfcb#

èhe }eve jlp}kteckqe`k>i# dkp}likfk%kded }eve vbeckqev ce bpèilovenne `bvbfvecl vbpliei`ke { pece db `kvrone# `li bc nki db }ldbv oeveitkqev ri bnk`kbitbpbv~k`kl)

2)6 LTVLP ]VL@BDKHKBITLP BPTBVBLTE@TK@LP)

Clp }e`kbitbp dbfbvei pbv vbhktkdlp dkvb`tehbitb e ce `liprcte bztbvie# `li rielvdbi db vbvikpkli = plck ktrd db tvetehkbitl }lv bc pbv~k kl db Ibrvl`kvrone)

Bi ce `liprcte pb vbeckqeve ce }vlovehe`k>i# nb`je { dke db jlp}kteckqe`kli) Bpte pbccb~eve e èfl bc dce db ce nb`je }vb~kpte }eve bc }vl`bdkhkbitl# = eitbp pburi cep`lidk klibp db ède }e kbitb

Pb jeve bc eieckpkp db clp bptrdklp db ceflvetlvkl b kheubilcluk`lp) Clp èplp }vlfcbhe pbvei dkp`rtkdlp bi ce arite db db`kpklibp urkvrvukèp) Clp }e`kbitbp jlp}kteckqedlp bi ltve hptktr`kli# dbfbi pbv `liprctedlp e ril db clp

bp}b keckptep dbc pbv~k kl }eve ertlvkqev bc tvepcedl) ]eve e`b}tev pr tvepcedl dbfb bptev tldl dbfkdehbitb }vlovehedl { dkp}likfcb#

èhe }eve jlp}kteckqe`kli) dkp}likfkckded }eve vbeckqev bp`bilovenne `bvbfvec =vbpliei`ke { pece db `kvrone)

2)0 ]CEIBE@KLI URKVRVOK@E

Bi ce pece db bpèilovenke `bvbfvec = db vbpliei`ke heuibtkè pb jeve bc eiec kpkpdb clp bzevibibp { pb pbcb``klievei clp }ritlp r lfabtk~lp db ce fkl}pke)

2)4 EDURKPK@KLI DB CE KINLVHE@KLI ]EVE BC ]VL@BDKHKBITL

Cep kvieubibp bpèiluvenkèp = db vbpliei`ke pbvei kh}vbpep bi nlvhetl db dlpkvieubibp }lv }ceè cep urb pbvei Kcb~edep ec hldrcl db `lvi}rte`kli }evevbeckqev clp èc`rclp bptbvbl te`tk`lp# db cep `llvdbiedep# frpèv bc }ritl dbbitvede hep `li~bikbitb { bc lfabtk~l db ce `kvrone { dkpbvkev cep tve{b`tlvkep {,l`liptvrkv bc dkpbnkl dbc ~lcrhbi db ce cbpkli urb pbve bztvendl

Bceflve`kli dbc he}e urcvrvuc`l) ch}vbpkli db ce kinlvhe`kli db cep `llvdbiedep# }ritl db bitvede { `llvdbiedepdb clp lfabtk~lp)

2)2 @KVROkE

Ce `kvrone pb vbeckqeve `li eibptbpke obibvec)

]eukie 0 db ?


4/7

@>dkol1 JP](OR(5;=O(==4

^bvpk>i1 5E C@ EC Dt E H E[ Ln c%DB FLOLTE l# #17EC^@K////////Hc .)&& F~kk&&&

@KVROKE BPTBVBLT EZK@EJlp}kte%

Pkhli Flck~evJLP]KT ECkQE@KLIIBRVL@KVROkE

Drveitb ce `kvrone pb vburkbvb ce }vbpbi`ke db rie erzkckev urb vb`kfe cephrbptvep# eiltb cep `llvdbiedep { cep ève`tbvkptkèp db ce hrbptve e hbdkde urbe~eiqe ce `kvrone)

Tbvhkieidl bc }vl`bdkhkbitl pb vbtkveve bc hev`l bptbvblte`tk`l# pb bceflveve cejlae db }etlcloke# eilteidl kep `llvdbiedep db ède nveohbitl }eve }ldbv}lptbvklvhbitb je`bv rie `lvvbce`k>i bitve ce jkptl}etlcloke# cep kheubibp { cepdknbvbitbp `llvdbiedep *Eibzl+

Dkeovehe`k>i db cep tve{b`tlvkep bh}cbedep { dkpbil dbc he}e dbnkiktk~b}lpturkvrvuk l *Eibzl+?) ECOLVKTHL DB E@TRE@KLI

Neokie 4 db k


5/7

JLP]KTECkQE@KLIIBRVL@KVROKE

@>dkol1 JP](OR(5;=O(==4KVROKE BPTBVBLTEZK@EJlp}kte%

Pkh>i Flck~evE C@ EC LK E H E[ L% 9LB) FLOLTE l)`)

^bvpk>i1 5

:)KIDK@EDLVBP DB BÊCRE@KLIIl) db }e`kbitbp etbidkdlp `li ce }etlcloce bp}b`knkèdeIl) db }e kbitbp kitbv~bikdlpIl) db }e kbitbp kinb`tedlpIl) db `lh}ck e`klibpHl) Db Bovbplp);) OCLPEVKLKDBNKIK@KLIBP

BPTBVBLTEZKE1Bptbvbltezke = bptbvblte`tke bp rie tbìkè urkvrvukè urb `lipkptb bi je`bv rieclètkqe`kli tvkdkhbipkliec db ri }ritl = }ritlp feped lp bi rie vbnbvbi`ke#hbdkeitb `llvdbiedep }lc evbp = èvtbpkeiep)FKL]PKE BPTBVBLTEZK@E1Ce Fkl}pke Bptbvbl te`tkè orkede }lv kheubibp db vbpliei`ke = bpèilovence bp riee}ckè`kli db ce tbìkè db bptbvblte`tke# }vl`bdkhkbitl urb pb vbeckqe bi eurbcclp}e`kbitbp urb }vbpbitei cbpklibp `bvbfvecbp urb vburkbvbi db ce `linkvhe`klijkptlclukè fe`tbvklclukè }eve }ldbv edvikikptvevpbcbp ri edb`redl { ve`kliectvetehkbitl)Bpte tbìkè }bvhktb lftbibv fkl}pkep `bvbfvecbp dkvkokdep# bi nlvhe pbvkede# db`recurkbv }evtb dbc `bvbfve# fepedl bi clp èc`rclp vbeckqedlp }lv ri `lh}rtedlv bp}lpkfcbbptefcb`bv bc `keuilptk l jkptlcluk`l {,l fe`tbvklkluk`l pburi cep ib`bpkdedbp#pki vbeckqev oveidbp }vl`bdkhkbitlp urkvrvok`lp { èpk db heibve ehfrcetlvke) )VBPB@@KLI ^LCRHBTVK@E DB CBPKLIBP @BVBFVECBP1Ce vbpb``kli ~lcrvibtvkè bp ltve e}ckè`kli db ce bptbvbltezke { `lipkptb bi vbeckqev#`li ce e{rde db rie kheobi bpèiluvenkè = db vbpliei`ke heuibtkè `bvbfvec bi`lidk`klibp bptbvbl te`tkèp# rie vb`liptvr``k>i bi }keilp èvtbpkeilp db ce kheobi#}lv hbdkl dbc `lh}rtedlv# kinlvhe`kli urb ec tveipnlvhevce bi }ritlp èvtbpkeilpplfvb }e}bc de lvkobi e ri }ceil hkihbtvt`l db ecte }vb kpkli)Bpte kinlvhe`kli tvepcedede e `llvdbiedep bptbvbl teìèp pbvei cep rtkckqedep `lhloRce drveitb bc }vl`bdkhkbitl urkvrvuk`l) cloveidl db bpte heibve je`bv rie vbpb``kli}vlnride = pr}bvnk`kec# pborve { `li rie bztbipkli }vbdbtbvhkiede }lv ce }ceibe`kliurkvrvukè)@VEIBLTLHKE ORKEDE ]LV BPTBVBLTE@TKE1Bpte e}ckè`kli tr~l dlp lvcobibp# }vkhbvl1 frpèvcb plcr`kli e cep dknk`rctedbp `li cepurb pb }rbdb bi`litvev bc `kvraeil }eve clèckqev kitvel}bvetlvkehbitb ecoriep cbpklibpdb }burbil tevieil# clèckqedep bi evbep `lvtkècbp bcl`rbitbp# urb }lv cepève`tbvcptkèp db ce cbpkli { db ce clèckqe`kli il }bvhktb vbeckqev rie bz}clve`kli }evece clèckqe`kli# }lv bc vkbpol urb bptl pkoiknkè)

]eokie 2 db ? )


6/7

@KVROKE BPTBVBLTEZK@E @>dkol1 JP](OR(5;=O(==4Ek))@E_EHE[LVDB FLOLTE l) #

) 1 7 ) 1 & / S ) )R t Kn?$)7#7))#)a $9)1& #=&&&&&&

Jlp}ktecPkhli Flck~ev

K ^bvpkli1 5LP]KTECKQE@KLIIBRVL@KVROKE

BK pboridl lvkobi pb fepe bi ce tbidbi`ke db ce ibrvl`kvroke hldbvie# db vbeckqev`veibltlhkep db }burbil tevieil# bi cep urb pb vburkbvb tbibv rie clèckqe`klibze`te plfvb ce cbpkli# `lidk`kli urb pb }rbdb è%`rcev }lv hbdkl dbc pkptbhe bptbvblte`tk`lDVBIEAB DB URKPTBP ]LV ]RI@KLI BPTBVBLTE@TK@E1Dbitvl db ce ~evkede oehe db }etlcloke kitve`veibeie# `li ecorie nvb`rbi`ke pblfpbv~ei cbpklibp `r{lp pkitlhep bptei vbce`kliedlp `li ce }vbpbi`ke db urkptbp# urb}vldr`bi bnb`tl `lh}vbpk~l { urb pr b~e`re`kli bp kh}lvteitb }lvurb }vldr`kvehbalvke db ce pkitlhetlcloke# }bvl urb }lv pr clèckqe`cli pb je`b dknn`kc e tve~bp db ce`kvroke `li~bi`kliec# = pktre`klibp bi cep urb bc `litbikdl dbc urkptb bp ce `ce~b }evebptefcb`bv bc dkeuilptk`l)DVBIEAB BPTBVBLTE@TK@L DB JBHETLHEP ]VLNRIDLP1Ce b~e`re`kli db jbhetlhep clèckqedlp kitve(Ezkec hbitb bi clp oeiocklp fepecbp =bi bc teccl `bvbfvec# je pkdb rie db cep kh}lvteitbp e}ckè`klibp db bpte tbìkè# }rbpe }bpev db ce ove~bded urb kh}ckè tbibv rie jbhlvveoke bi bpte qlie db `bvbfvl `lipr b~e`re`kli# pb }rbdb hbalvev bc }vlilptk`lFVEURKTBVE]KE KITVECBPKLIEC1Ce kh}ceite`kli db prptei`kep vedkle`tk~ep `lhl ktvkrh# {ldl# lvl# dbitvl db cepè~kdedbp db ecorilp trhlvbp# je`b }evtb dbc tvetehkbitl bnb`tk~l eitkibl}cepk`l)]vl`bdkhkbitl pborvl# dlidb pb b~ktei ecorilp db clp vkbpolp db ce `kvroke`li~bi`kliec) )^BITVK@RCLPTLHKE BIDLP@L]KE BPTBVBLTE@TK@E1Bptb bp ri }vl`bdkhkbitl ectbvietk~l e ce dbvk~e`kli ~bitvk`rcev# bi èplp dbjkdvl`bnecke lfptvr`tk~e# lèpkliedl }lv ce bptbilpkp `liubikte dbc e`rbdr`tl db Pkc~kll }lv ce lfptvr``kli dkvb`te = kidkvb`te db ce `kv`rce`kli db ckurkdl `bneclvveurkdbl# bi bce`rbdr`tl `bvbfvec# lèpkliede }lv cbpklibp trhlvecbp urb babv`bi }vbpkli plfvb prp}evbdbp = cep lfptvr{bi)

@ljbi HA) PTBVBLTP@TK@ PRVOBV[1 Dkeoilpkp# B~ecretkli eidHeieobhbit) Ibw [lvg1 Ve~bi ]vbpp# 5;:>)

@KVROKE NRI@KLIEC1Ce `kvroke nri`kliec `liptktr{b ri ovr}l db }vl`bdkhkbitlp ibrvlurkvrvok`lp dlidb pbje`b bptkhrce`kli { ,= cbpkli db ecoriep ~kep = ir`cblp `bcrcevbp }eve frpèv prbptkvirce`kli = kijtfk`kli frpèidl ri vbprctedl bp}b`knk`l# }eve bc `litvlc db ripkitlhe ibrvlcluk`l# }lv babh}cl `litvlc dbc tbhfclv bi ce binbvhbded db ]evgkipli#@litvlc db ce vkokdbq bi ce binbvhbded db ]evgkipli# @litvlc db ce eovbpk~kded bi}e`kbitbp `li dbp`litvlc dbc kh}rcpl)5=) FKFCKLOVENKE

]eokie > db ?


7/7

@>dkol1 JP](OR(5;=O(==4E K) )@ EC Dk E H E[ LVDB FLOLTE l)`)

p)#)#_t%y1a)(1)y)11)%%P7 3S)& *g#n&&

@KVROKE BPTBVBLTEZK@EJlp}ktec

Pkhli Flck~evJLP]KTECKQE@KLI

IBRVL@KVROKE^bvpk>i1 5

@kiecck O) Vbikbv D# Pbfeo Pekitb Vlpb @# Evierd B# ]kbvvb Geji) E) @jvlik`tlipkccev jbviketkli ki @vlrqlip eid E}bvnpp{idvlhbp1 tjb vlcb ln }vbhetrvbp{ilptlpkp ln tjb cehfdlkd prtrvb) A Ibrvlprvo 5;;27 :012?2(2:6

Nkpjhei HE# Jloei OV Dldob ]V) Tjb `li`rvvbi`b ln j{dvl`b}jecrp eid`veiklp{ilptlpkp) A Ibrvlprvo 5;?57 041 >65(>6;

Pkddkuk PI# ]lpik`g A@# Fri`kb V# bt ec tjb dbtb`tkli eid heieobhbit lnkitve`veikec j{}bvtbipkli entbv kiktkec prtrvb vbcbepb eid db`lh}vbppkli nlv`veiklne`kec d{plptlpkp p{idvlhbp) Ibrvlprvobv{ 5;;27 0>1?=0(?=:

Pekitb(Vlpb @# Ce @lhfb A# ]kbvvb(Gjei E# Vbikbv D# Jkvp`j A# kitve`veikec~bilrp pkirp j{}bvtbipkli1 èrpb lv `lipburbi`b ln j{dvl`b}jecrp kikineitp) A) Ibrvlprvo 5;:47 >=1?6?(?0>

@jlrz H# Vl``l @# Jl`gcb{ E ) _ecgbv H) ]bdketvk` Ibrvlprvobv{) 6==6)55) VBOKPTVLPJkptlvke @ccikèB}k`vkpkpLvdbi db Plck ktrdLvdbi db PeckdeNlvhetl db Nlvhrce`k>i db Hbdkèhbitlp b Kiprhlp Hbdk`lp@bvtkn k edl db Dbnri`k>iNlvhetl Rik`l db Db~lcr`k>i db Hbdkèhbitlp b KiprhlpCkfvl db Vbokptvl db ]etlcloke56) EIBZLP

Bpte orke il obibve eibzlp)

]eucie ? db ?

hsp-gu-190g-004 cirugia estereotaxica

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