====== Pipeline ======


see [[Pipeline embolization device]]
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In **neurosurgery**, a pipeline typically refers to a structured process that ensures patient care, [[neurosurgical planning]], and [[postoperative]] [[follow-up]] are managed effectively. This pipeline helps maintain [[consistency]], improve [[patient outcome]]s, and [[streamline]] [[workflow]]s across [[multidisciplinar]]y [[team]]s.
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 Here’s an example of a neurosurgical pipeline definition:

1. **Referral and Intake**:
   - **Source**: Referrals from primary care, emergency departments, or other specialists.
   - **Evaluation**: Triage cases based on urgency (e.g., emergency, urgent, elective).
   - **Data Collection**: Gather patient history, previous imaging, and relevant medical records.

2. **Preoperative Assessment**:
   - **Diagnostics**: Imaging (MRI, CT scans, angiography) and functional assessments to understand pathology.
   - **Multidisciplinary Review**: Consult with neurologists, oncologists, radiologists, and anesthesiologists if needed.
   - **Risk Assessment and Consent**: Assess surgical risks, educate the patient on potential outcomes, and obtain informed consent.
   - **Surgical Planning**: Use navigation tools, such as Medtronic head navigation or stereotactic systems, to precisely map the surgical route.

3. **Surgical Preparation**:
   - **OR Preparation**: Set up necessary equipment (microscopes, neuronavigation, intraoperative imaging).
   - **Patient Positioning**: Ensure optimal access to the surgical site while minimizing risks (e.g., pressure sores, nerve damage).
   - **Team Briefing**: Conduct a preoperative briefing with the OR team to review the surgical plan.

4. **Intraoperative Phase**:
   - **Real-Time Imaging**: Use neuronavigation, intraoperative MRI/CT, and ultrasound as needed.
   - **Surgical Procedure**: Perform the surgical intervention based on preoperative planning, using appropriate instruments and techniques.
   - **Monitoring**: Track vital signs, brain/spinal cord function, and potential complications.

5. **Immediate Postoperative Care**:
   - **ICU Monitoring**: Transfer patient to ICU or a recovery unit for close observation.
   - **Neurological Assessment**: Perform initial neurological exams to evaluate function and recovery.
   - **Pain Management**: Manage pain using analgesics or anesthetics as per protocols.

6. **Postoperative Follow-Up**:
   - **Imaging**: Perform postoperative scans (e.g., CT or MRI) to confirm success and assess for complications.
   - **Rehabilitation**: Engage physical/occupational therapy if needed, especially for cases involving functional loss.
   - **Outpatient Follow-Up**: Regular follow-ups for clinical evaluation and monitoring, with timing based on case specifics.

7. **Quality Control and Case Review**:
   - **Outcome Evaluation**: Review surgical outcomes, complications, and patient recovery.
   - **Case Review and Documentation**: Document each case thoroughly, with data for quality improvement, morbidity, and mortality meetings.
   - **Continuous Improvement**: Integrate lessons from each case to refine protocols, techniques, and technology use.

8. **Research and Education**:
   - **Data Collection**: Use anonymized data for research on surgical outcomes or technique improvements.
   - **Training**: Use cases as educational material for residents, fellows, and interdisciplinary learning.

Each phase in the neurosurgery pipeline can benefit from a team-based approach to maximize safety, precision, and continuity of care for patients.