Hamel, W;
Koeppen, JA;
Hariz, M;
Krack, P;
Moll, CKE;
(2016)
The Pioneering and Unknown Stereotactic Approach of Roeder and Orthner from Gottingen. Part I. Surgical Technique for Tailoring Individualized Stereotactic Lesions.
Stereotactic and Functional Neurosurgery
, 94
(4)
pp. 240-253.
10.1159/000448080.
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Abstract
During the 1950s through the 1970s, Hans Orthner and Fritz Roeder, two German neurologists from Göttingen, developed a sophisticated technique to perform functional stereotactic surgery with outstanding accuracy. They introduced direct air ventriculography performed in the same surgical session as the ablative stereotactic procedure. For individualized surgical targeting, Orthner prepared a stereotactic atlas (>60 brains) with an ingenious brain-slicing device, the Göttinger macrotome. Brains were grouped based on similarity of six different head and ventricle measurements. A brain cluster representing the best match for a patient was selected for stereotactic targeting. Stereotactic lesions were tailored in an individual manner and shaped by stringing together multiple small coagulations following intraoperative test stimulation. This was achieved from a single probe trajectory by using well-engineered string electrodes with calibrated curving and involved laborious calculations. Only high-frequency thermocoagulation was regarded as appropriate for lesioning. With this meticulous technique, the most advanced stereotactic procedures were performed, including bilateral pallidotomy that ultimately could be restricted to the ansa lenticularis and ventromedial hypothalamotomy, the most delicate stereotactic operation performed to date. Outside Göttingen, this technique has only been used by Prof. Dieter Müller in Hamburg, Germany. This elaborate stereotactic approach is widely unknown and deserves to be discussed in a historical context.
| Type: | Article |
|---|---|
| Title: | The Pioneering and Unknown Stereotactic Approach of Roeder and Orthner from Gottingen. Part I. Surgical Technique for Tailoring Individualized Stereotactic Lesions |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1159/000448080 |
| Publisher version: | http://dx.doi.org/10.1159/000448080 |
| Language: | English |
| Additional information: | Copyright © 2016 S. Karger AG, Basel. All rights reserved. This is the peer-reviewed but unedited manuscript version of the following article: [insert full citation, e.g. Cytogenet Genome Res 2014;142:227–238 (DOI: 10.1159/000361001)]. The final, published version is available at http://www.karger.com/?doi=10.1159/000448080 |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Neurosciences, Neuroimaging, Surgery, Neurosciences & Neurology, History, Stereotactic surgery, Stereotactic lesioning, Pallidotomy, Ventriculography, Targeting, Brain atlas, Bilateral Thalamotomy, Parkinsons Disease, Chemopallidectomy, Ventriculography, Stimulation, Pallidotomy, Surgery |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1516769 |
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