Related Experiment Video
Updated: May 30, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Freehand technique for putaminal hemorrhage--technical note
Kimihiko Yokosuka1, Masaaki Uno, Kazuhiro Hirano
1Department of Neurosurgery, Kawasaki Medical School, Kurashiki, Okayama, Japan. hiko@med.kawasaki-m.ac.jp
Insights
A new endoscopic surgical technique for putaminal hemorrhage offers a safe and effective treatment. This freehand method successfully removed hematomas with minimal complications in patients.
Area of Science:
- Neurosurgery
- Minimally Invasive Surgery
- Medical Imaging
Background:
- Putaminal hemorrhage is a severe type of intracerebral hemorrhage often requiring surgical intervention.
- Traditional surgical approaches can be invasive, carrying significant risks and potential complications.
- Developing less invasive and effective surgical techniques is crucial for improving patient outcomes.
Observation:
- A novel freehand endoscopic surgical technique was developed for putaminal hemorrhage.
- Three-dimensional imaging derived from CT scans was utilized for precise surgical planning.
- Intraoperative reference points included the nasion and external auditory foramen, with the globus pallidus to insula median point as the target.
Findings:
- The freehand endoscopic technique was applied to 15 patients with putaminal hemorrhage.
- All procedures required a single puncture with no reported complications.
- The median surgical time was 91.7 minutes, achieving a median hematoma removal rate of 95.9%.
Implications:
- The freehand technique represents a simple, safe, and effective endoscopic approach for putaminal hemorrhage.
- This method offers a less-invasive alternative for hematoma evacuation, potentially reducing patient morbidity.
- Further research may validate this technique as a standard of care for putaminal hemorrhage treatment.
Abstract:
We designed a new endoscopic surgical procedure for putaminal hemorrhage (freehand technique) and evaluated its effectiveness and safety in patients with putaminal hemorrhage. Computed tomography (CT) data sets from 40 healthy patients were used. The CT data were transformed into three-dimensional images using AZE VirtualPlace(TM) Plus. The nasion and external auditory foramen were the intraoperative reference points. The median point from medial of the globus pallidus to the insula was the target point. The location of the burr hole point was 80-125 mm above and 27.5 mm lateral to the nasion, and the direction was parallel to the midline and a line drawn from the burr hole to the ipsilateral external auditory foramen. This point was used for 15 patients with putaminal hemorrhage. In all cases, only one puncture was required, and there were no complications. The median surgical time was 91.7 minutes, and the median hematoma removal rate was 95.9%. No recurrent bleeding or operative complications occurred. The freehand technique is a simple and safe technique for patients with putaminal hemorrhage. We believe that this technique of endoscopic hematoma evacuation may provide a less-invasive method for treating patients with putaminal hemorrhage.
