Live from AANS: The Power of Convenience in Neurosurgery

Craniotomies have come a long way since Harvey Cushing, the father of “effective” neurosurgery. According to a 2010 New York Times article, “Inside Neurosurgery’s Rise,” Cushing became the first surgeon in history who could open the skull of living patients with a ‘reasonable certainty that his operations would do more good than harm.’ And he did so often using only the local anesthetic Novocain.

Even though diagnostic and technological advancements have made cranial-maxillofacial operations less burdensome for both the patient and the surgeon, these types of procedures can still be physically and mentally demanding.

At this year’s American Association of Neurological Surgeons (AANS) Annual Meeting we asked one of our customers, CMF Medicon, for their perspective on innovations to CMF procedures that enhance the efficiency of simple to complex cranial repair and reconstruction.

“With regard to cranial closure systems, a device that has become a must-have for neurosurgeons is the battery-powered screwdriver,” noted Kevin Vucinich, executive vice president at CMF Medicon Surgical Inc. “Especially after a challenging surgery that may have lasted several hours, many surgeons want a powered device to easily and reliably reconnect the cranial flap.”

In order to add the most value to their neurosurgery customers, Medicon had their battery powered screwdriver designed and manufactured with a variable speed and torque set so it could be used for multiple applications (neuro., maxillofacial, etc.), and ready-to-use batteries that fit compactly and locked securely in the back. The powered screwdriver was also carefully developed to complement the couplings for Medicon’s systems, including their screwdriver blade and aggressively threaded screws.

“We worked with Pro-Dex to ensure that when the surgeon loaded our screws into our screwdriver blade, it could be done in one, easy motion. It was also important to make absolutely certain that the screwdriver blade would reliably hold the screw while accurately penetrating the bone,” explained Vucinich. “Regardless of where the location is on the scull, our battery-powered screwdriver helps surgeons efficiently and securely fixate the cranial bone flap after a craniotomy, and do so using less pressure.”

An informal survey we conducted with a few neurosurgeons attending this year’s AANS affirmed that, whether a surgeon uses a powered device or manual screwdriver comes down to personal preference.

Some prefer the tactile feel of manually connecting the screw to the plate. As one neurosurgeon observed, “We’re a lot like carpenters in that way.” Others see using a battery-powered driver to complete the craniotomy as an extension of all the other technology that was used during the surgery.

Regardless of the innovation, at the end of the day, surgeons just want to perform the best surgery they can to save their patient’s life and improve their outcomes. And safe, reliable, efficient technology supports their ability to do that.

As a surgeon, what’s your preference for a cranial closure—powered or manual device? If it depends, what does it depend on (number of surgeries scheduled, where patient is in their treatment, etc.)? Are there certain features you like/dislike in a powered surgical screwdriver?

Tricia Rodewald is marketing director at Pro-Dex Inc. (Irvine, CA).