As time changes the procedures also must change. Certain instruments which have been very useful since inception have lost their value. The burrs, perforators, bone nibblers, spine cutters which were very essential till today are rarely or not needed. The practice of laminectomy will soon see its demise. Just to give an example a right sided tumour at C1C2 level was removed by me today without sacrificing even a mm of bone although tumour had anterior and right lateral relation to thecal sac. Similarily over the last one year no laminectomy has been done by me and all the cranial tumours have been done by my own designed trephine. I have stopped nibbling temporal bone to reach middle fossa and all posterior fossa tumours including acoustic have been removed through craniotomy only. Burr hole practice has been stopped . For chronic subdural collection a tangential drill hole is made and 12 or 10 no Foley"s catheter is inserted and connected to sterile bag, ensuring that no air enters subdural space. It has given excellent results. Where solid component is there 1.5 cm trephine is made and bone is replaced at the end.

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Professor Karam Chand I'm very curious about your trephine with dura guard. Can we see some picture?

Thank you
The information can be obtained from info@avmhealthcare.com. Thanks for your interest.

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