Intracоuveuse neurosurgery (literature review and prospects)

INTRODUCTION. The relevance of neonatal neurosurgery is increasing due to the annual increase in the number of previous births. Children with very low and extremely low body weight are often in critical condition, which can be complicated by pathology that requires emergency intervention by cardiac surgeons, surgeons or neurosurgeons. Transportation of such infants from the neonatal intensive care unit to the operating room leads to huge risks of comlication (e.g., hypothermia, interruption of treatment of the underlying disease, accidental extubation, hypo/hyperventilation, accidental removal of the vascular access, inadequate monitoring etc.). To reduce these risks, “bedside” technologies for diagnosing and treating surgical pathology of newborns are being developed. The most complex and poorly studied is currently intracouveuse neurosurgery technologies, which include intracouveuse neuroimaging, intracouveuse invasive neurodiagnostics and intracouveuse operative neurosurgery (puncture and open operations). A key unresolved issue is the study of the neurosurgical risks of performing operations inside the incubator (inadequacy of surgical navigation and/or volume of surgery, as well as the possibility of increased infectious complications). Solving these problems is the basis for assessing the prospects for the development of intracouveuse neurosurgery.

AIM. Analysis of domestic and foreign literature to assess the possibilities and prospects for the use of intracouveuse neurosurgical technologies for neurosurgical pathology in newborns.

MATERIALS AND METHODS. Literature search was carried out using the detabases PubMed, eLibrary.ru using the keywords “bedside surgery”, “bedside neonatal neurosurgery”, “bedside surgery intensive care”, “intracоuveuse neurosurgery”, “intracоuveuse surgery”. A review of 56 messages published between 1977 and 2024 was carried out.

RESULTS. The concept of neonatal bedside surgery is widespread in world practice and has found its application in various fields of surgery. It eliminates many high risks that arise when transporting a newborn from the neonatal intensive care unit to the operating room. Analysis of the data confirms the absence of intra- and postoperative complications during bedside abdominal and cardiac surgical interventions, however, the possibility of safe use of bedside neurosurgical diagnostic and therapeutic manipulations in the world literature is described very few and needs further study.

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