Neurosurgery Equipment: What a Hospital Needs to Start a Service

Patient positioning and head fixation

Almost every cranial and upper spinal case begins with positioning. The OR table must support supine, lateral, prone and sometimes sitting positions, and a head fixation system holds the skull rigidly in the chosen position. Radiolucent versions such as the DORO LUCENT Headrest System are used where intraoperative CT or X-ray is planned.

A department should plan for several systems: a standard clamp, a non-invasive horseshoe headrest for suitable cases and, for children, pediatric pin holders or gel pads. See head fixation system buying guide for the selection criteria.

Power tools for craniotomy

Bone work uses a motor system with interchangeable handpieces. A cranial perforator makes burr holes, a craniotome cuts the bone flap, and other attachments are used for drilling and shaping. The NOUVAG Craniotome is a high-speed handpiece with a dura protector, operating from 1,000 to 60,000 rpm through an INTRA (ISO 3964) coupling, with turned or diamond milling tools. See the NOUVAG Craniotome.

When specifying, confirm that motor, handpieces and foot switch are one system, how many handpieces are included and how milling tools are supplied. Our article on craniotomy steps and equipment shows where each tool is used in the procedure.

• Cranial perforator for burr holes
• Craniotome with dura protector for bone flaps
• Motor or control unit with foot switch
• Milling tools, burs and drill bits

Retractors, microinstruments and neurosurgical instruments

Brain retraction and micro-instruments are a large part of a neurosurgical set. Retractor systems attach to the skull clamp or the table and hold blades in position without a person holding them. The microsurgical instrument sets cover fine scissors, forceps, dissectors, suction tubes and aneurysm clips.

REDA's neurosurgery range includes Ferris-Smith-Kerrison punches, Caspar and laminectomy rongeurs, Yasargil micro instruments and aneurysm clips, and Fergusson and Frazier suction tubes; see REDA neurosurgery instruments. More on naming is in our article about neurosurgical instruments and their names.

Do not forget the support items that make a set usable: instrument trays and containers for sterile processing, bipolar forceps with a suitable generator, and cottonoid and pattie handling. Clinical teams normally define the exact content of each tray, while the purchasing team checks that reprocessing capacity can handle the volume.

Monitoring: ICP and neuro-ICU equipment

Postoperative and trauma care calls for intracranial pressure monitoring. The standard methods are invasive: external ventricular drains and intraparenchymal probes. Newer non-invasive approaches use ultrasound of the optic nerve sheath. The Nisonic P-100 is a CE-marked ultrasound system running FAST-ICP software, which the manufacturer states is currently for research use only.

Beyond ICP, a neuro-ICU needs ventilators, monitors with invasive pressure channels, infusion pumps and, where available, EEG. Overview in ICP monitoring devices.

OR infrastructure and supplier support

The surrounding infrastructure is as important as the instruments: a table with the right accessories, surgical lights, a surgical microscope or exoscope, navigation, intraoperative imaging if planned, suction and electrosurgery. Layout and utilities are discussed in our guide to neurosurgery operating room setup.

Beckfinity supplies neurosurgery equipment from several manufacturers, including Black Forest Medical, NOUVAG, REDA and Nisonic, to hospitals in the UAE. To plan a department list or request a quote, contact our specialists.