Minimally invasive lesionectomies through a stereotactically guided working sleeve

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Stereotactic Surgery

Background:

• Resection of deep-seated brain lesions near critical structures like the thalamus and basal ganglia presents significant surgical challenges.
• Traditional surgical approaches may carry higher risks of neurological deficits.
• Minimally invasive techniques are being developed to improve safety and efficacy.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel minimally invasive stereotactic technique for resecting lesions in challenging brain locations.
• To assess outcomes in patients undergoing resection of tumors and epilepsy-related lesions in the thalamus, basal ganglia, third ventricle, and temporal lobe.

Main Methods:

• Stereotactic, MRI/CT-guided resection using a specialized PAN working sleeve.
• Minimally invasive approach through frontal, occipital, or zygomatic burr-holes.
• Technique applied in 39 patients over four years for various intracranial lesions.

Main Results:

• Successful resection in 39 patients, including astrocytomas, cavernomas, metastases, and lesions causing intractable epilepsy.
• Total resection achieved in 17 patients with lesions in the foramen of Monro and third ventricle.
• Four patients with intractable epilepsy achieved complete seizure freedom with no observed deficits post-operatively.

Conclusions:

• The PAN working sleeve enables minimally invasive stereotactic resection of deep-seated brain lesions with favorable outcomes.
• This technique demonstrates efficacy in treating complex tumors and intractable epilepsy, offering a potentially safer alternative to open surgery.
• Further research can explore long-term outcomes and broader applications of this approach.