Commissurotomy Anterior

Anterior commissurotomy: main aspects and application

Commissurotomy anterior, also known as Greenfield Commissurotomy Anterior, is a neurosurgical procedure that has important implications in the medical field. In this article we will review the main aspects of anterior commissurotomy and its application in clinical practice.

An anterior commissurotomy is a surgical procedure in which the anterior commissure, a structure in the brain that connects the right and left hemispheres, is cut. This procedure is performed to reduce seizure activity or improve the treatment of certain neurological and psychiatric conditions, such as epilepsy and uncontrolled chronic pain.

One of the main uses of anterior commissurotomy is to treat epilepsy, especially in patients who have failed conservative treatments such as antiepileptic drugs. By cutting the anterior commissure, surgery creates a barrier to the propagation of electrical impulses between the hemispheres of the brain, which can lead to a reduction in the frequency and severity of epileptic seizures.

In addition, anterior commissurotomy can be used to relieve chronic pain in patients who have failed other treatments. By destroying the anterior commissure, the procedure blocks the transmission of pain signals between the hemispheres of the brain, which can significantly reduce sensitivity to pain.

It is important to note that anterior commissurotomy is a major neurosurgical procedure and should only be performed under close medical supervision and guidance from experienced professionals. Patients undergoing this procedure should be thoroughly counseled about the potential risks and benefits of this procedure.

In conclusion, anterior commissurotomy is an important neurosurgical procedure that can be an effective treatment for epilepsy and chronic pain. However, the decision to undergo this procedure should be made after careful discussion with medical specialists and taking into account the individual characteristics of each patient.

Anterior commissurotomy is the most common option for thoracoscopy. Usually performed for thoracic aortic aneurysm or other pleural interventions. Through a longitudinal or transverse sternotomy incision, the right and left costophrenic foramen, mediastinum and upper surface of the pericardium are dissected. The mediastinal pleura is turned to the right and left, respectively. The aortic root capsule is dissected and the anterior surface of the thoracic aneurysmal aorta with its bifurcation is isolated. The site of ligation of the aneurysmal dilatation is bluntly separated from the anterior surface of the thoracic aorta with tweezers and, without tension, the end of the aorta is ligated and crossed. The aneurysm cavity is drained through the counter-aperture and a gauze tube is inserted into the aneurysmal sac through the formed window. Double-row sutures are placed on the chest incision.