Foley's catheter- multiple uses in Neurosurgery


Foley catheter inserted on both side through small trephines for drainage of chronic subdural haematomas

http://www.neurosurgic.com/index.php?option=com_myblog&show=foleys-catheter-no-10-and-12-as-drainage-catheter-in-chronic-subdural-haematomas.html&Itemid=337 


Please refer to my earlier blog whose URL is given above. Foley's catheter is a very versatile catheter which is used commonly for drainage of urinary bladder. Apart from use in urinary system it is of immense help in neurosurgery also. It has found use as a very good  tool for achieving retraction of brain as needed in aneurysm surgery and CP angle tumours. By gradually expanding the balloon a space is made for Leyla retractor. The soft nature of its baloon, with incremental expansion of balloon  prvents any injury to cortical surface.  I am putting images of 2 patients where I have used it for this purpose.   

Top most picture is of a patient operated yesterday for left acoustic tumour. Bottom 2 images are of a patient operated for A Com and left carotid bifurcation aneurysms yesterday.

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written by anarfeyzi, January 16, 2012
thanks for discribing so novel neurosurgical technique))....I've never read, see or read about it. Thanks, it may be useful for us, too.
Foley catheter
written by sharmakchand, January 23, 2012
Frederic Foley was a surgeon in Boston, Massachusets in 1930s. Manufacturer has named the catheter after him. Catheter has aprofound influence in medicine. Syrige, leucoplast, catheter and stethoscope are among the common tools found everwhere with doctors. Foley catheter is used not only for urinary drainage but has its use as cervix dilator in labour, as a drainage catheter in surgery of all kinds, for stopping epistaxis and as a constricting band to make veins prominent for blood sampling and starting intravenous drip. In my set up it is used as a preferred drain for chronic subdural haematoma. After making a drill hole or small trephine catheter is inserted into subdural cavity and since it has a baloon, the catheter is pulled back afetr it is inflated with 1 to 2 cc saline and helps in stopping bleedind from dural puncture site. The soft nature of material is ideal since it does not cause brain injury.
At times it may become difficult to deflate balloon by aspiration and in that event injection of ether into balloon or direct puncure of balloon through needle passed from skin may have to be done.
Foley catether as brain retractor
written by neurostar, January 28, 2012
At the pediatric neurosurgical unit - Hopital Necker Enfants malades, a needle attached to a glove finger inflated with saline solution is currently used in order to obtain brain retraction for deep seated lesions of the brain, no new idea at all; Foley appears too bulky to me, unless you use a pediatric one.



BIOMET KINDtm Neuro Balloon Retractor
written by r.dammers, January 29, 2012
The idea is useful in general for opening of the Sylvian fissure or interhemispheric approaches for example. Nevertheless, it is not novel as is claimed. Please be referred to http://www.lorenzsurgical.com/product.php?item=7
for a description of the KINDtm Neuro Balloon Retractor, which was developed by prof. Krisht, ANI, Little Rock, Arkansas, USA in 2007.
Furthermore, the use of (cheaper) cotton patties for retraction has already been described by prof. Yasargil in his important monographs.
Foley catheter
written by sharmakchand, January 30, 2012
I am personally grateful for a discussion about the topic. Obviously not everyone will agree with me. The beauty of Foley catheter is that it is availablr everywhere and also is made in ,any sizes. The balloon has capacity of 50 ml,although you hardly need that much inflated balloon, but in larger cavities after tumour resection it comes handy to achieve haemostasis.
Foley catheter
written by callis, February 04, 2012
Dear Colleague, congratulation for the use you do of a Foley.
I invite you to read a paper that I published on Acta Neurochirurgica (Bubbles in the head: a new method for brain retraction during craniotomy. Spena G, Versari P. Acta Neurochir (Wien). 2011 Sep;153(9):1807-11. Epub 2011 Jul 15) about the use I do of a Fogarty balloon as soft brain retractors in many different situation. I hope the paper will inspire you in trying yourself. Best regards.
Giannantonio Spena
greetings
written by sharmakchand, February 05, 2012
Dear Dr Spena,
Thanks for your kind comments. You have interests similar to mine. One of my favourite subject is Chiari malformation with Syringmyelia. I have written quite a bit about it on this site. I request you to go through those blogs and want to know your thought on the subject. My surgery provides the best resolution of syrinx and has eliminated the risks associated with intradural procedures at foramen magnum.
Foley catheter
written by sharmakchand, February 16, 2012
Foley catheter has become a part of my instrument trolley. I use it everytime I approach CP angle tumours and supresellar exposure. The gradual expansion of balloon provides atraumatic expansion of space needed for application of Leyla retractor. Catheter is also connected to a saline bottle to provide continuous irrigation. Whenever a cavity is craeted as in temporal or frontal lobectomy, catheter balloon is used for achieving haemostasis.
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written by sharmakchand, July 29, 2012
continued use
written by sharmakchand, July 29, 2012
Use of Foley catheter is essential in all surgeries done by me. 5cc to 10 cc inflation of balloon is normally enough to widen subarachnoid space. With this technique one can have an option of opening sylvian fissure and suprasellar cisterns. If ventricles are dilated a 5no infant feeding tube, is put in frontal horn and adequate csf is drained on same side or in some cases on contralateral side.
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