Minimally invasive neurosurgery : MIN
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Minim Invasive Neurosurg · Aug 2011
Simple, effective, supine positioning for the retrosigmoid approach.
The retrosigmoid approach is often used for posterior fossa pathology. Many variations of positioning exist. Here, we report a simple, safe, and quick positioning technique which maximizes patient safety, surgeon comfort, and intraoperative view. ⋯ Supine positioning for the retrosigmoid approach is an excellent and safe positioning alternative.
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Minim Invasive Neurosurg · Aug 2011
Review Case ReportsNeuroendoscopic management of intraventricular germinoma at the foramen of Monro: case report and review of the literature.
Intraventricular tumors account for approximately 3% of adult brain tumors and 16% of childhood and adolescent brain tumors. Half of the intraventricular tumors in adults and one quarter of those in children are found in the lateral ventricles. Ependymoma, astrocytoma, oligodendroglioma, choroid plexus papilloma, meningioma and subependymal giant cell astrocytoma are the common tumors encountered at this particular site. A germinoma at this site is rare. Microsurgery of intraventricular tumors can be challenging and is performed with potential functional and cognitive complications. ⋯ This report suggests that in selected cases endoscopic resection of an intraventricular tumor under frameless neuronavigation guidance is feasible and safe. The target can be precisely located and procedure-related adverse events can be minimized.
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Minim Invasive Neurosurg · Aug 2011
The supraorbital approach for recurrent or residual suprasellar tumors.
Suprasellar tumors can be removed through a variety of approaches including conventional frontotemporal craniotomies, the transsphenoidal route, or the supraorbital (SO) eyebrow craniotomy. Herein we assess the utility of the SO route for recurrent or residual suprasellar tumors previously treated by an alternative route. ⋯ The SO approach should be considered as a safe and effective alternative route for recurrent or residual suprasellar tumors previously treated by conventional craniotomy or TS surgery. It typically offers a simplified trajectory that minimizes scar tissue from prior approaches and provides excellent access for optic apparatus decompression. Endoscopy is helpful to visualize hidden tumor remnants and maximize safe tumor removal.
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Minim Invasive Neurosurg · Aug 2011
Minimally invasive retropleural approach for central thoracic disc herniation.
The management of symptomatic thoracic disc herniation (TDH) has evolved tremendously ever since the first laminectomy was performed. The last decade has witnessed the evolution of minimally invasive approaches for TDH most of which have been posterior/posterolateral. Traditional anterior approaches involve a thoracotomy or more recently, thoracoscopic techniques. The authors describe a less invasive anterior retropleural surgical approach to address central thoracic disk herniations which is less extensive than a thoracotomy and allows better anterior access than posterior or posterolateral approaches. The retropleural approach allows the use of the operative microscope with a tubular retractor in the anterior thoracic spine. ⋯ A minimally invasive retropleural approach using tubular retractor system for central thoracic disc herniation is feasible and may be a less invasive anterior alternative to a thoracotomy.
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Minim Invasive Neurosurg · Aug 2011
Purely endoscopic removal of intraventricular brain tumors: a consensus opinion and update.
The main purpose of this project is to define the major indications, preferences, techniques, limitations, and complications associated with intraventricular tumor removal using purely endoscopic techniques. ⋯ Endoscopic intraventricular surgery is a feasible minimally invasive alternative to open transcranial surgery for specific ventricular tumors. With the currently available instrumentation, the technique can be applied to small avascular solid intraventriclular tumors and colloid cysts of the third ventricle. The majority of the complications are based on hemostasis potential. The development of compatible instrumentation with an enhanced ability for solid tumor removal and more adequate hemostasis appear to be the principle limitations in furthering the technique of endoscopic removal of intraventricular brain tumors.