Microsurgery

Together with leading experts from the clinic and medical technology, Fraunhofer ILT is developing novel laser-based therapeutic processes for the precise cutting of bones with short-pulse laser radiation. In addition, it is evaluating new laser procedures for the coagulation of blood vessels and for dermatological therapies.

So that surgeons can better use specific microsurgical methods, Fraunhofer ILT is developing applicators with which they can safely use therapeutic laser processes in OR. These include compact handpieces with integrated mini-scanner technology for dosing therapeutic laser radiation at the treatment site as well as optical sensors for the in-situ monitoring of laser cutting and coagulation processes. Fraunhofer ILT develops the applicators and sensors on customer order as OEM components and integrates them into laser-based therapeutic systems.

The services “Microsurgical Systems” offers range from feasibility studies and prototype development to the implementation of small series devices.

Microsurgical Systems

• “Cold” tissue ablation with USP lasers
• Laser surgery
• Laser coagulation
• Dermatological laser processses
• Mini-scanner technology

Antal, D., Altenmüller, D., Dümpelmann, M., Scheiwe, C., Reinacher, P., Crihan, E., Ignat, B., Cuciureanu, I., Demerath, T., Urbach, H., Schulze‐Bonhage, A., Heers, M.:
Semiautomated electric source imaging determines epileptogenicity of encephaloceles in temporal lobe epilepsy.
Epilepsia, online first, (13 S.) (2024)
http://dx.doi.org/10.1111/epi.17879 (Open Access)

Kunz, L., Staresina, B.P., Reinacher, P.C., Brandt, A., Guth, T.A., Schulze-Bonhage A., Jacobs J.:
Ripple-locked coactivity of stimulus-specific neurons and human associative memory.
Nature 27, 587-599 (2024)
https://doi.org/10.1038/s41593-023-01550-x (Open Access)

Sajonz, B., Frommer, M., Reisert, M., Blazhenets, G., Schröter, N., Rau, A., Prokop, T., Reinacher, P., Rijntjes, M., Urbach, H., Meyer, P., Coenen, V.:
Disbalanced recruitment of crossed and uncrossed cerebello-thalamic pathways during deep brain stimulation is predictive of delayed therapy escape in essential tremor.
NeuroImage: Clinical 41, 103576, (2024)
http://dx.doi.org/10.1016/j.nicl.2024.103576 (Open Access)

Würtemberger, U., Diebold, M., Rau, A., Akgün, V., Becker, L., Beck, J., Reinacher, P., Taschner, C., Reisert, M., Fehrenbacher, L., Erny, D., Scherer, F., Hohenhaus, M., Urbach, H., Demerath, T.:
Advanced diffusion imaging reveals microstructural characteristics of primary CNS lymphoma, allowing differentiation from glioblastoma.
Neuro-Oncology Advances 6(1), vdae093, (10 S.), (2024)
http://dx.doi.org/10.1093/noajnl/vdae093 (Open Access)

Giesen, C., Bochvarov, L., Müller, L., Nyga, S., Reinacher, P., Lenenbach, A.:
Efficient and tissue-saving bone ablation with a pulsed 3 µm laser source.
PROCEEDINGS OF SPIE, (2023)
https://doi.org/10.1117/12.2668183

Giesen C., Bochvarov L., Yo Y.M., Bogdoll M., Vervoort S., Lenenbach A.:
High-Speed Laser Drilling for Dental Implantation: Ablation Process and Applicator Technology.
Current Directions in Biomedical Engineering -(2023)
https://doi.org/10.1515/cdbme-2023-1162

Lauer, E., Riegler, E., Mutter, J., Alig, S., Bleul, S., Kuehn, J., Ranganathan, L., Klingler, C., Demerath, T., Würtemberger, U., Rau, A., Weiß, J., Eisenblaetter, M., Bamberg, F., Prinz, M., Finke, J., Duyster, J., Illerhaus, G., Diehn, M., Alizadeh, A., Schorb, E., Reinacher, P., Scherer, F.:
Improved early outcome prediction by MRI-based 3D tumor volume assessment in patients with CNS lymphomas.
Neuro-Oncology 26(2), 374-386, (2024)
http://dx.doi.org/10.1093/neuonc/noad177

Scheiwe, C. , Grauvogel, J., Csók, I., Fistouris, P., Fung, C., Beck, J., Reinacher, P.C., Roelz, R.:
Cisterno-Ventricular Lavage After Aneurysm Clipping for the Prevention of Delayed Infarction in Patients With Subarachnoid Hemorrhage.
Neurosurgery Practice 4, 49- (2023)
https://doi.org/10.1227/neuprac.0000000000000049

Reinacher, P.C., Cimniak, A., Demerath, T., Schallner, N.:
Usage of augmented reality for interventional neuraxial procedures: A phantom-based study.
European Journal of Anaesthesiology 39,1-9 (2022)
https://doi.org/10.1097/EJA.0000000000001755

Coenen, V., Schlaepfer, T., Meyer, D., Kilian, H., Spanier, S., Sajonz, B., Reinacher, P., Reisert, M.:
Resolving dyskinesias at sustained anti-OCD efficacy by steering of DBS away from the anteromedial STN to the mesencephalic ventral tegmentum – case report.
Acta Neurochirurgica (5 S.), (2022)
http://dx.doi.org/10.1007/s00701-022-05206-w (Open Access)

Coenen, V., Sajonz, B., Hurwitz, T., Böck, M., Hosp, J., Reinacher, P., Urbach, H., Blazhenets, G., Meyer, P., Reisert, M.:
A Neuroanatomy of Positive Affect Display – Subcortical Fiber Pathways Relevant for Initiation and Modulation of Smiling and Laughing.
Frontiers in Behavioral Neuroscience 16, (14 S.), (2022)
http://dx.doi.org/10.3389/fnbeh.2022.817554  (Open Access)

Coenen, V., Schlaepfer, T., Sajonz, B., Reinacher, P., Döbrössy, M., Reisert, M.:
“The Heart Asks Pleasure First”—Conceptualizing Psychiatric Diseases as MAINTENANCE Network Dysfunctions through Insights from slMFB DBS in Depression and Obsessive–Compulsive Disorder.
Brain Sciences 12(4), 438 (11 S.) (2022)
http://dx.doi.org/10.3390/brainsci12040438 (Open Accesss)

Coenen, V.A., Döbrössy, M.D., Teo, S.J., Wessolleck, J., Sajonz, B.E.A., Reinacher, P.C.,  Thierauf-Emberger, A., Spittau, B., Leupold, J., von Elverfeldt, D., Schlaepfer T.E., Reisert, M.:
Diverging prefrontal cortex fiber connection routes to the subthalamic nucleus and the mesencephalic ventral tegmentum investigated with long range (normative) and short range (ex-vivo high resolution) 7T DTI.
Brain Structure and Function 227, 23-47 (2022)
https://doi.org/10.1007/s00429-021-02373-x (Open Access)

Csók, I., Grauvogel, J., Scheiwe, C., Bardutzky, J., Wehrum, T., Beck, J., Reinacher, P., Roelz, R.,
Basic Surveillance Parameters Improve the Prediction of Delayed Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage.
Frontiers in Neurology 13, 774720- (2022)
http://dx.doi.org/10.3389/fneur.2022.774720

Egger, K., Rau, A., Urbach, H., Reisert, M., Reinacher, P.:
3D X-ray based visualization of directional deep brain stimulation lead orientation.
Journal of Neuroradiology 49(3), 293-297, (2022)
http://dx.doi.org/10.1016/j.neurad.2021.05.002

Fistouris, P., Scheiwe, C., Grauvogel, J., Csók, I., Beck, J., Reinacher, P., Roelz, R.:
Mitigation of Blood Load Impact in Patients with Subarachnoid Hemorrhage by Cisternal Lavage.
Cerebrovascular Diseases 51, 499-505, (2022)
http://dx.doi.org/10.1159/000521203

Klingler, J., Naseri, Y., Reinacher, P., Hoedlmoser, H., Urbach, H., Hohenhaus, M.:
Patient radiation exposure from intraoperative computed tomography in spinal surgery.
The Spine Journal, Article in Press (2022)
http://dx.doi.org/10.1016/j.spinee.2022.03.008

Kogias, E., Altenmüller, D., Karakolios, K., Egger, K., Coenen, V., Schulze-Bonhage, A., Reinacher, P.:
Electrode placement for SEEG: Combining stereotactic technique with latest generation planning software for intraoperative visualization and postoperative evaluation of accuracy and accuracy predictors.
Clinical Neurology and Neurosurgery, 213, 107137, (2022)
http://dx.doi.org/10.1016/j.clineuro.2022.107137  

Meyer, D., Spanier, S., Kilian, H., Reisert, M., Urbach, H., Sajonz, B., Reinacher, P., Normann, C., Domschke, K., Coenen, V., Schlaepfer, T.:
Efficacy of superolateral medial forebrain bundle deep brain stimulation in obsessive-compulsive disorder.
Brain Stimulation 15(3), 582-585 (2022)
http://dx.doi.org/10.1016/j.brs.2022.03.004  (Open Access)

Roelz , R., Scheiwe, C.,  Grauvogel, J.,  Csok, I., Coenen, V. A., Beck, J.,  Reinacher, P.C.:
Early cisternal fibrinolysis is more effective than rescue spasmolysis for the prevention of delayed infarction after subarachnoid haemorrhage.
Stroke and Vascular Neurology 7, 108-113, (2022)
http://dx.doi.org/10.1136/svn-2021-001146

Steiert, C., Behringer, S., Kraus, L., Bissolo, M., Demerath, T., Beck, J., Grauvogel, J., Reinacher, P.:
Augmented reality–assisted craniofacial reconstruction in skull base lesions — an innovative technique for single-step resection and cranioplasty in neurosurgery.
Neurosurgical Review (2022)
http://dx.doi.org/10.1007/s10143-022-01784-6 (Open Access)

Scheerer, F., Jacobs-LeVan, J., Metzger, S.M., Schönberger, J., Wagner, K., Schulze-Bonhage, A., Reinacher, P.C., Klotz, K.A.:
Lateralizing signs in patients with Hypothalamic Hamartoma.
Epilepsia 63, 101- (2022)
https://doi.org/10.1111/epi.17388

Kunz, L., Staresina, B., Reinacher, P.C., Brandt, A., Guth, T.G., Schulze-Bonhage, A., Jacobs, J.:
Ripple-locked coactivity of stimulus-specific neurons supports human associative memory.
bioRXiv (72 S.), (2022)
https://doi.org/10.1101/2022.10.17.512635

Belachew, N., Diebold, M., Reinacher, P., Prinz, M., Urbach, H., Erny, D., Taschner, C.:
Freiburg Neuropathology Case Conference.
Clinical Neuroradiology 32, 875-881 (2022)
http://dx.doi.org/10.1007/s00062-022-01195-6

Babst, N., Isbell, L., Rommel, F., Tura, A., Ranjbar, M., Grisanti, S., Tschuch, C., Schueler, J., Doostkam, S., Reinacher, P., Duyster, J., Kakkassery, V., von Bubnoff, N.:
CXCR4, CXCR5 and CD44 May Be Involved in Homing of Lymphoma Cells into the Eye in a Patient Derived Xenograft Homing Mouse Model for Primary Vitreoretinal Lymphoma.
International Journal of Molecular Sciences 23,11757- (2022)

http://dx.doi.org/10.3390/ijms231911757

Demerath, T., Stanicki, A., Rölz, R., Farina Nunez, M., Bissolo, M., Steiert, C., Fistouris, P., Coenen, V., Urbach, H., Fung, C., Beck, J., Reinacher, P.:
P55 Accuracy of augmented reality-guided (AR) drainage versus stereotactic and conventional puncture in an intracerebral hemorrhage phantom model.
Journal of NeuroInterventional Surgery (JNIS) 14, Issue Suppl 2, A30, (2022)

http://dx.doi.org/10.1136/neurintsurg-2022-esmint.76

Straehle, J., Erny, D., Neidert, N., Heiland, D., El Rahal, A., Sacalean, V., Steybe, D., Schmelzeisen, R., Vlachos, A., Mizaikoff, B., Reinacher, P., Coenen, V., Prinz, M., Beck, J., Schnell, O.:
Neuropathological interpretation of stimulated Raman histology images of brain and spine tumors: part B.
Neurosurgical Review 45(2), 1721-1729, (2022)
http://dx.doi.org/10.1007/s10143-021-01711-1 (Open Access)

Bissolo, M., Scheiwe, C., Csók, I., Grauvogel, J., Beck, J., Reinacher, P., Roelz, R.,
Introduction of cisternal lavage leads to avoidance of induced hypertension and reduced cardiovascular complications in patients with subarachnoid hemorrhage.
Journal of Clinical Neuroscience 94, 286-291 (2021)
http://dx.doi.org/10.1016/j.jocn.2021.09.036

Coenen, V. A., Sajonz, B. E., Reinacher, P. C., Kaller, C. P., Urbach, H., Reisert, M.:
A detailed analysis of anatomical plausibility of crossed and uncrossed streamline rendition of the dentato-rubro-thalamic tract (DRT(T)) in a commercial stereotactic planning system.
Acta Neurochirurgica 163(10), 2809-2824, (2021)
https://doi.org/10.1007/s00701-021-04890-4 (Open Access)

Demerath, T., Donkels, C., Reisert, M., Heers, M., Rau, A., Schröter, N., Schulze-Bonhage, A., Reinacher, P., Scheiwe, C., Shah, M., Beck, J., Vlachos, A., Haas, C., Urbach, H.:
Gray-White Matter Blurring of the Temporal Pole Associated With Hippocampal Sclerosis: A Microstructural Study Involving 3 T MRI and Ultrastructural Histopathology.
Cerebral Cortex 32(9), 1882-1893, (2021)
http://dx.doi.org/10.1093/cercor/bhab320

Dümpelmann, M., Reinacher, P., Kravalis, K., Jagschies, L., Tittelbach, M., Coenen, V., Schulze-Bonhage, A.:
A subgaleal electrode array for neurostimulation allows the recording of relevant information in closed loop applications.
Journal of Neuroscience Methods 362, 109295- (2021)
http://dx.doi.org/10.1016/j.jneumeth.2021.109295

Giesen, C., Bochvarov, L., Erben, B., Reichelt, S., Hoefer, M., Müller, L., Reinacher, P., Lenenbach, A.:
Laser ablation of bone tissue with Q-switched infrared laser sources for neurosurgical applications.
SPIE BIOS. 6-12 March 2021, Online Only, California, United States.
Proceedings Volume 11627, Photonic Therapeutics and Diagnostics in Dentistry, Head and Neck Surgery, and Otolaryngology; 116270B (2021)
https://doi.org/10.1117/12.2577117

Klotz, K. A., Scheiwe, C., Reinacher, P.C., Antonio-Arce, V.S., Schulze-Bonhage, A., Demerath, T., Shah, M.:
Kallosotomien bei Sturzanfällen und epileptischen Spasmen.
Zeitschrift für Epileptologie 34(2), 175-180 (2021)
https://doi.org/10.1007/s10309-021-00398-0 (Open Access)

Krüger, M, Naseri, Y., Cavalloni, F., Reinacher, P.C., Kägi, G., Weber, J., Brogle, D., Bozinov, O., Hägele-Link, S., Brugger, F.:
Navigated Deep Brain Stimulation Surgery: Evaluating the Combined Use of a Frame-Based Stereotactic System and a Navigation System.
Stereotactic and Functional Neurosurgery 99(1), 48-54 (2021)
https://doi.org/10.1159/000510528

Krüger, M.T., Naseri, Y., Cavalloni, F., Reinacher, P.C., Kägi, G., Weber, J., Brogle, D., Bozinov, O., Hägele-Link, S., Brugger, F.,
Do directional deep brain stimulation leads rotate after implantation?.
Acta Neurochirurgica 163, 197-203 (2021)
https://doi.org/10.1007/s00701-020-04568-3

Neidert, N., Straehle, J., Erny, D., Sacalean, V., El Rahal, A., Steybe, D., Schmelzeisen, R., Vlachos, A., Reinacher, P., Coenen, V., Mizaikoff, B., Heiland, D., Prinz, M., Beck, J., Schnell, O.:
Stimulated Raman histology in the neurosurgical workflow of a major European neurosurgical center — part A.
Neurosurgical Review 45, 1731-1739, (2021)
http://dx.doi.org/10.1007/s10143-021-01712-0

Rau, A., Roelz, R., Urbach, H., Coenen, V. A., Demerath, T., Reinacher, P. C.:
Application of Augmented Reality in Percutaneous Procedures-Rhizotomy of the Gasserian Ganglion.
Operative Neurosurgery 21(3), 160-164 (2021)
https://doi.org/10.1093/ons/opab155 (Open Access)

Rau, A., Urbach, H., Coenen, V. A., Egger, K., Reinacher, P. C.:
Deep brain stimulation electrodes may rotate after implantation—an animal study.
Neurosurgical Review 44, 2349-2353 (2021)
https://doi.org/10.1007/s10143-020-01429-6 (Open Access)

Roelz , R., Schubach , F., Coenen, V.A., Jenkner, C., Scheiwe, C., Grauvogel, J., Niesen, W.-D., Urbach, H., Taschner, C.,  Seufert, J., Kätzler, J., Beck, J., Reinacher , P. C:
Stereotactic cisternal lavage in patients with aneurysmal subarachnoid hemorrhage with urokinase and nimodipine for the prevention of secondary brain injury (SPLASH): study protocol for a randomized controlled trial.
Trials 22(1), 285- (15 S.), (2021)
https://doi.org/10.1186/s13063-021-05208-6 (Open Access)

Roelz, R., Grauvogel, J., Csok, I., Schäfer, J.-H., Shah, M., Fung, C., Taschner, C., Beck, J., Reinacher, P. C., Scheiwe, C.,
Patterns of intracerebral hemorrhage that result in unfavorable outcomes in patients with subarachnoid hemorrhage.
Clinical Neurology and Neurosurgery 205, 106603- (2021)
https://doi.org/10.1016/j.clineuro.2021.106603

Steiert, C., Grauvogel, J., Roelz, R., Demerath, T., Schnell, D., Beck, J., Coenen, V. A., Reinacher, P.C.:
Stereotactic cysto-ventricular catheters in craniopharyngiomas: an effective minimally invasive method to improve visual impairment and achieve long-term cyst volume reduction.
Neurosurgical Review 44, 3411-3420 (2021)
https://doi.org/10.1007/s10143-021-01510-8

Kunz, L., Brandt, A., Reinacher, P. C., Staresina, B. P., Reifenstein, E. T., Weidemann, C. T., Herweg, N. A., Tsitsiklis, M., Kempter, R., Kahana, M. J., Schulze-Bonhage, A., Jacobs, J.:
A neural code for egocentric spatial maps in the human medial temporal lobe.
Preprint auf bioRxiv 2020.03.03.973131, (44 S.),(2020)
https://doi.org/10.1101/2020.03.03.973131  (Open Access)

Lauer, E. M., Waterhouse, M., Braig, M., Mutter, J., Bleul, S., Duque-Afonso, J.,  Duyster, J., Marks, R., Reinacher, P. C., Prinz, M., Illerhaus, G., Finke, J.,  Schorb, E., Scherer, F.:
Ibrutinib in patients with relapsed/refractory central nervous system lymphoma: A retrospective single-centre analysis.
British Journal of Haematology 190(2), e110-e114, (2020)
https://doi.org/10.1111/bjh.16759  (Open Access)

Reinacher, Peter C., Schlaepfer, Thomas E., Schick, Martin A., Beck, Jürgen, Bürkle, Hartmut, Schumann, Stefan,
When Resources Are Scarce - Feasibility of Emergency Ventilation of Two Patients With One Ventilator.
Preprint auf medRxiv, 2020.04.10.20060525 (8 S.), (2020)
https://doi.org/10.1101/2020.04.10.20060525 (Open Access)

Roelz, R., Schaefer, J. H., Scheiwe, C., Sajonz, B., Csok, I., Steiert, C., Buttler, J., Rohr, E., Grauvogel, J., Shah, M. J., Egger, K., Niesen, W.-D., Bardutzky, J., Beck, J., Coenen, V. A., Reinacher, P. C.:
Impact of Stereotactic Ventriculocisternostomy on Delayed Cerebral Infarction and Outcome After Subarachnoid Hemorrhage.
Stroke 51(2), 431-439 (2020)
https://doi.org/10.1161/STROKEAHA.119.027424

Reinacher, P.C., Schulze-Bonage, A.:
Spezifische stereotaktische Optionen zur Behandlung seltener Epilepsien, basierend auf hypothalamischen Hamartomen.
Zeitschrift für Epileptologie 32, 319-325 (2019)
https://doi.org/10.1007/s10309-019-0273-7  

Tulea, C.-A., Caron, J., Gehlich, N., Lenenbach, A., Noll, R., Loosen, P.:
Laser cutting of bone tissue under bulk water with a pulsed ps-laser at 532 nm
J. Biomed. Opt. 20 (10), 105007 (9 S.) (2015)
https://doi.org/10.1117/1.JBO.20.10.105007

Sandner, T., Kimme, S., Grasshoff, T., Todt, U., Graf, A., Tulea, C., Lenenbach, A., Schenk, H.:
Micro-scanning mirrors for high-power laser applications in laser surgery
Int. Conf. on Optical MEMS and Nanophotonics 2013, August 18-22,  Kanazawa, Japan, 3-84 (2013)
https://doi.org/10.1117/12.2042671

Tulea, C., Caron, J., Wahab, H., Gehlich, N., Hoefer, M., Esser, D., Jungbluth, B., Lenenbach, A., Noll, R.:
Highly efficient nonthermal ablation of bone under bulk water with a frequency-doubled Nd: YVO4 picosecond laser
SPIE BIOS, 2-7 February 2013, San Francisco, California, United States
Proceedings Volume 8565, Photonic Therapeutics and Diagnostics IX; 85656E (2013)
https://doi.org/10.1117/12.2004392  

Arens, J., Brouwer, P. de, Mager, I., Brucker, C., Schäfer, M., Jacobs, P., Schmitz-Rode, T., Steinseifer, U.
Hemocompatibility tests on materials for a multi-tactile-sensor concept
Int. J. Artif. Org. 33 (7), S. 480, (2010)
https://doi.org/10.1177/039139881003300708

Our services cover a wide range of topics. Related topics to Microsurgical Systems and further research and development focuses can be found under the following links.