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All Journal International Journal of Integrated Health Sciences Neurologico Spinale Medico Chirurgico
Sevline Estethia Ompusunggu
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Robotic Surgery for Giant Presacral Dumbbell-Shape Schwannoma Farid Yudoyono; Muhammad Zafrullah Arifin; Rully Hanafi Dahlan; Sevline Estethia Ompusunggu; Shin Dong Ah; Yi Seong; Ha Yoon; Yoon Do Heum; Kim Keung Nyun
International Journal of Integrated Health Sciences Vol 3, No 1 (2015)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Objective: To demonstrate the feasibility of using da Vinci robotic surgical system to perform spinal surgery.Methods: Magnetic resonance imaging (MRI) of a 29-year-old female patient complaining right pelvic pain for 1 month revealed a 17x8x10 cm non-homogeneous dumbbell shape encapsulated mass with cystic change located in the pelvic cavity and caused an anterior displacement of urinary bladder and colon.Results: There was no systemic complication and pain decrease 24 hours after surgery and  during 2 years of follow up. The patient started a diet 6 hours after the surgery and was discharged 72 hours after the surgery. The pathological diagnosis of the tumor was schwannoma. Conclusions: Giant dumbbell shape presacral schwannomas are rare tumours and their surgical treatment is challenging because of the complex anatomy of the presacral. Clinical application of da Vinci robotic surgical system in the spinal surgical field is currently confined to the treatment of some specific diseases or procedures. However, robotic surgery is expected to play a practical future role as it is minimally invasive. The advent of robotic technology will prove to be a boon to the neurosurgeon.Keywords: da Vinci robotic surgical system, presacral, schwannoma DOI: 10.15850/ijihs.v3n1.407
Brachial Plexus Surgery Sevline Estethia Ompusunggu; Rully Hanafi Dahlan
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
Publisher : Indoscholar

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The magnitude problems of brachial plexus lesions are not only about the surgical approaches but also the basic problems. Its vague clinical symptoms, the complexity of anatomy structure, the use of advanced imaging followed by electrophysiology to address the lesions, and the challenging of surgical timing and options make those lesions management more challenging. These challenges in Indonesia are more difficult because not so many neurosurgeons are familiar with brachial plexus surgery. Brachial plexus surgery is in evolution. For brachial plexus nerve sheath tumours, a fascicular level resection of tumours and preservation of uninvolved fascicles is now possible. Neuropathic pain may be improved by a dorsal root entry zone lesion procedure. The timing of surgery is different in each pathology, especially in traumatic injury. In traumatic injury, it depends on several factors, e.g. the mechanism of injury, type of injury, the speed of the vehicle, and the mode of fall while victim lands on the ground. The common surgical options in traumatic injury are direct repair by means of an end-to-end suture, external neurolysis, nerve grafting, and nerve transfers. Secondary reconstruction to improve function has been widely introduced such as soft-tissue reconstruction (tendon/muscle transfer or free muscle transfer) and bone procedures (arthrodesis or osteotomy). Brachial plexus surgery demands a broad multidisciplinary approach to a common problem, targeting not only the peripheral nerve, but also the brain, spinal cord, muscle, end-organ, bone and joints, and their complex interactions.
Cervical Spine Trauma Management Rully Hanafi Dahlan; Sevline Estethia Ompusunggu; Farid Yudoyono
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
Publisher : Indoscholar

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The incidence of spine injury following accidents are still very high in developing countries. Many problems occur after the accident including primary intervention on the scene, transportation to the public primary hospital, the referral system, and finally, the management at the central hospital. Cervical spinal cord injuries represent 20-33% of total spinal injuries with the prevalence of the subaxial levels. In patients with a preoperative neurological deficit due to spine trauma, in case of spinal cord compression or instability, surgery is often the treatment of choice to grant a chance of neurological recovery, early mobilization, and faster return to usual daily activities compared to the conservative treatment. In the past, many authors suggested a delayed surgical treatment to reduce postoperative complications rate, but recent studies have shown that an early decompression (< 72 h) may facilitate a postoperative neurological improvement probably due to the prevention of the secondary mechanisms of damage in acute SCI. In the context of the advanced management of spinal injuries, the main points of the focused assessment, the important waypoints of a full classification of the skeletal and spinal cord injury, the principles of early prioritization and decision making, the outline of the surgical strategy including indications, timing, approaches, technique and post-operative care, and the outline principles of rehabilitation. The authors in this paper try to summarize and create a guideline of management, based on experience in a regional centre.
Co-Authors Farid Yudoyono Ha Yoon Kim Keung Nyun Muhammad Zafrullah Arifin Rully Hanafi Dahlan Shin Dong Ah Yi Seong Yoon Do Heum