Frequently asked Questions

When will VBAS be used The device can be used in posterior fossa tumors such as large acoustic neuromas and meningiomas when an internal decompression approach is used. Because the distal margins of these tumors tend to remain fixed to dura or bone during internal decompression, navigational guidance during removal allows for safety to surrounding structures and prevention of traversal tumor margins inadvertently. The TC device also provides for excellent access for far lateral approaches to the foramen magnum and C1/C2 region in the removal of tumors etc. The small port TC model (12mm) is also ideally suited for removal of intracerebral hematomas, third ventriculostomy, colloid cyst excision etc. We strongly feel that the small port TC model will compete successfully with endoscopic approaches currently being popularized because it offers both neuronavigational capability and binocular vision by way of a truly minimally invasive approach that stands up to endoscopic claims. We believe the EC model allows for impressive exposure to lesions around the brain, such as meningiomas (subtemporal, subfrontal, falcine, inferooccipital etc.), posterior fossa aneurysms requiring a subtemporal approach, trans-callosal approaches to intraventricular tumors. Through further development with additional products in the pipeline, we believe we will for the first time allow for a minimally invasive approach to anterior circulation aneurysms and trans-sylvian approaches to posterior circulation aneurysms to provide both navigational confidence and a better exposure than possible with most large craniotomy, extensive sylvian dissection approaches. The view is truly impressive. The retraction problems that commonly occur after anterior communicating artery aneurysm surgery are also eliminated. We believe to also be able to offer a significant advantage whereas most aneurysms can be included in the elliptical working channel: in cases where intraoperative aneurysmal rupture occurs, bleeding is contained in the working channel itself, thus preventing diffuse dispersion of subarachnoid blood while the problem is being brought under control. The SF will also provide minimally invasive neuronavigational access to tumors along the base such as sphenoid wing and cavernous meningiomas, large supra-sellar pituitary tumors and craniopharyngiomas.

Does the VBAS have any limitations  None, which we can see. The access port can be easily manoeuvred, particularly with IGS capatability. The field of view is in fact impressive, and surrounding tissues are visualized through the optically transparent working channel. We feel that keyhole surgery is made both safer and simpler with VBAS.

What do you think about VBAS & IGS-supported retractor positioning  With the VBAS the retraction and creation of a surgical corridor under image guidance is simultaneous. With the ability to center the pointer in the cup of the distal tip, the tip of the VBAS introducer literally becomes the “pointer” on the Image Guided System (IGS). A future development of the VBAS, which is subject to regulatory review, will add an optional  clip to the proximal end of the introducer to allow an IGS pointer to be firmly held in place during surgery. This will allow single-handed use of the pointer and the VBAS.

What are the safety constraints  The VBAS is made of polished polycarbonate and slides very easily along brain tissue. It does not adhere to tissues, even after prolonged periods of time. Therefore, interposed materials are no longer necessary to protect the brain from adhesion to the access device. We do, however, recommend that the device be rinsed thoroughly with sterile saline and left moistened prior to insertion. The VBAS is designed for minimally invasive neurosurgery. No retraction or pulling is required during positioning of the device. Additional benefit of the device is that it eliminates brain shift, allowing for a straight path to the target without lateral displacement of the brain or target. For each centimeter of depth of placement, the amount of brain displacement is less with the VBAS device than would be required with standard retraction. Meticulous hemostasis is standard of care in brain surgery. As the polished polycarbonate tubular surface does not adhere to the surrounding brain, removal does not cause bleeding, as occurs with the removal of cotton etc. after prolonged periods of time with standard retraction systems. Made of polished transparent polycarbonate, the VBAS increases a surgeon’s field of vision through a clear, visible and stable channel, allowing for continual monitoring of surrounding tissue and structures during surgery. The optical clarity of the polished polycarbonate allows the surgeon to immediately detect any bleeding that may occur around its pathway. This is a significant improvement over standard metal retractors and the opaque cotton or foam materials used with blade retractors to absorb liquids during surgery which impacts the surgeons’ visibility. Since the VBAS does not cause overdue brain compression, the need to reposition a standard retractor and “control” local pressure has been alleviated. This should make for a calmer and more confident surgical experience.

What about bleeding, is this a concern Another design consideration for using polycarbonate rather than metal is that transmission of electrocautery energy is not possible with plastic devices, thus eliminating the possibility of electrical burning of exposed tissues.:

How can I purchase Vycor products These devices are intended to be used only under the orders of a physician only and cannot be purchased by consumers. Vycor Medical Inc.’s products are used when certain brain procedures need to be performed. To purchase VBAS for your hospital, please contact Vycor Medical.

Why the need for these devices  They were created by surgeons for surgeons.

How does the VBAS differ from current retractors  Current retractors are often referred to as “blade retractors” or “ribbon retractors.” Independently, they are unable to create clear working channels for procedures. They often need additional products such as cottonoids or gauze to help create a working channel for the surgeon. The VBAS gives the surgeon the capability of using one device that provides both access and visualization to the surgical site and then instantly becomes a clear working channel upon removing the introducer.

What is the VBAS  The VBAS, is a brain retractor system that was designed to give the surgeon direct access to the surgical site and then simultaneously create a working channel for the surgeon to work within. It is comprised of a series of devices that come in various lengths and diameters to assist the surgeon in reaching various regions of the brain in surgery.

MRI Compatibility  The VBAS device is non-magnetic. It is composed of polycarbonate plastic and a non-magnetic, metallic spring that is encased in the device latch. It has not been evaluated for safety and compatibility in the MR environment.