Cost effective and fast craniotomy in Meningiomas.

Trephine craniotomy is the fastest way to open the cranium. Trephine can be made almost on any part of skull. William B Scoville was a pioneer in practicing trephine craniotomy. His visit to Vellore in India around 1964 was instrumental in introducing trephine craniotomy. Author has made trephine craniotomy very safe and cost effective with introduction of adjustable dura guard. In more than 90 percent of cases author uses trephine craniotomy. Above pictures from top to bottom- 1 and 2. Excised meningiomas 3. BrainLab Image guided system and Muller microscope. 4. MRI showing two meningiomas 5. Trephined bone in a case of left parietal meningioma operated on 27/8/10. 6. Trephined bone inside out showing bony grooves for hypertrophied meningeal vessels. 7. Meningioma in a middle aged female operated by trephine craniotomy in April 2010 in Korean Hospital, Addis Ababa. 8. Picture of Karam Chand trephine with adjustable dura guard. The trephine is available in various diameters.
Even for acoustic tumours and other posterior fossa tumours author routinely uses trephine craniotomy.


Above 3 images are of a young lady who was operated for right temporal meningioma on 8/11/2010. A right temporal trephine craniotomy was made using 5.25 cm Karam Chand trephine having adjustable dura guard. A quick and safe craniotomy was done without any injury to underlying dura. The meningeal arteies were under-run with 3,0 vicryl and obliterated before opening dura. Complete excision was done, good haemostasis was achieved with surgiflo(from Johnson and Johnson), trephined bone was replaced after applying hitch sutures.

See video on trephine craniotomy on http://www.youtube.com/watch?v=wp3iJaHXvmg

Comments (4)Add Comment

meningioma
written by sharmakchand, November 08, 2010
I have posted pictures of a patient operated for right temporal meningioma. A quick 5.25 cm trephine craniotomy was done. Surgiflo achieves very good haemostasis.
FRCS Ed
written by efrnh, July 17, 2011
I tend to use Scoville's trephine in epidurals and in small tumours. I would be interested to know the diameter ot Dr Chand's trephine and where to order it from. I presume it uses a centering drill?
trephine
written by sharmakchand, July 20, 2011
Sir,
The trephine is available in 1.5 t0 5.25 cm diameter. My trephine has adjustable dura guard. !.5 cm and 2.0 cm trephines need central removable pin to make a groove but in my experience 4cm and 5.25 cm trephine do not need central pin, although again detachable pin is supplied with it. Special scalp retractor developed by me provides excellent exposure after straight scalp incisions. For trephine and retractor please contact info@avmhealthcare.com and also you can search on google- avm healthcare delhi and fourbhai udyog delhi. See you sometime in Mexico.
Karam Chand trephine with adjustable dura guard
written by ci0, February 19, 2014
MARKETING, FINANCE AND DISTRIBUTION is the key, once any new equipment is considered safe and valuable and cost effective.

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