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Foley's catheter- multiple uses in Neurosurgery

Foley catheter inserted on both side through small trephines for drainage of chronic subdural haematomas

http://www.neurosurgic.com/index.php?option=com_myblog&show=foleys-catheter-no-10-and-12-as-drainage-catheter-in-chronic-subdural-haematomas.html&Itemid=337

Please refer to my earlier blog whose URL is given above. Foley's catheter is a very versatile catheter which is used commonly for drainage of urinary bladder. Apart from use in urinary system it is of immense help in neurosurgery also. It has found use as a very good tool for achieving retraction of brain as needed in aneurysm surgery and CP angle tumours. By gradually expanding the balloon a space is made for Leyla retractor. The soft nature of its baloon, with incremental expansion of balloon prvents any injury to cortical surface. I am putting images of 2 patients where I have used it for this purpose.

Top most picture is of a patient operated yesterday for left acoustic tumour. Bottom 2 images are of a patient operated for A Com and left carotid bifurcation aneurysms yesterday.

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Comments (5)

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written by anarfeyzi, January 16, 2012

thanks for discribing so novel neurosurgical technique))....I've never read, see or read about it. Thanks, it may be useful for us, too.

Foley catheter
written by sharmakchand, January 23, 2012

Frederic Foley was a surgeon in Boston, Massachusets in 1930s. Manufacturer has named the catheter after him. Catheter has aprofound influence in medicine. Syrige, leucoplast, catheter and stethoscope are among the common tools found everwhere with doctors. Foley catheter is used not only for urinary drainage but has its use as cervix dilator in labour, as a drainage catheter in surgery of all kinds, for stopping epistaxis and as a constricting band to make veins prominent for blood sampling and starting intravenous drip. In my set up it is used as a preferred drain for chronic subdural haematoma. After making a drill hole or small trephine catheter is inserted into subdural cavity and since it has a baloon, the catheter is pulled back afetr it is inflated with 1 to 2 cc saline and helps in stopping bleedind from dural puncture site. The soft nature of material is ideal since it does not cause brain injury.
At times it may become difficult to deflate balloon by aspiration and in that event injection of ether into balloon or direct puncure of balloon through needle passed from skin may have to be done.

Foley catether as brain retractor
written by neurostar, January 28, 2012

At the pediatric neurosurgical unit - Hopital Necker Enfants malades, a needle attached to a glove finger inflated with saline solution is currently used in order to obtain brain retraction for deep seated lesions of the brain, no new idea at all; Foley appears too bulky to me, unless you use a pediatric one.

BIOMET KINDtm Neuro Balloon Retractor
written by r.dammers, January 29, 2012

The idea is useful in general for opening of the Sylvian fissure or interhemispheric approaches for example. Nevertheless, it is not novel as is claimed. Please be referred to http://www.lorenzsurgical.com/product.php?item=7
for a description of the KINDtm Neuro Balloon Retractor, which was developed by prof. Krisht, ANI, Little Rock, Arkansas, USA in 2007.
Furthermore, the use of (cheaper) cotton patties for retraction has already been described by prof. Yasargil in his important monographs.

Foley catheter
written by sharmakchand, January 30, 2012

I am personally grateful for a discussion about the topic. Obviously not everyone will agree with me. The beauty of Foley catheter is that it is availablr everywhere and also is made in ,any sizes. The balloon has capacity of 50 ml,although you hardly need that much inflated balloon, but in larger cavities after tumour resection it comes handy to achieve haemostasis.