A 3D endoscopic transtubular transcallosal approach to the third ventricle

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Endoscopic Techniques

Background:

• Surgical access to third ventricle lesions is challenging.
• Traditional transcallosal approaches risk neurological deficits due to fornix/ventricle wall retraction.
• Minimally invasive techniques are needed to improve safety and outcomes.

Purpose of the Study:

• To evaluate the feasibility of a 3D endoscopic transcallosal approach using a tubular retractor for third ventricle lesions.
• To assess the safety and efficacy of this minimally invasive technique.

Main Methods:

• Performed 3D endoscopic transtubular transcallosal approaches on 5 cadaveric heads.
• Utilized neuronavigation for bur hole placement and endoscopic visualization for retractor insertion.
• Evaluated transforaminal, interforniceal, and transchoroidal modifications.

Main Results:

• The approach provided superior visualization of the third ventricle.
• Achieved stable retraction of the corpus callosum and fornices.
• Facilitated easy use of bayonetted instruments and applied consistent pressure on the corpus callosum.

Conclusions:

• A transtubular approach to the third ventricle is feasible.
• Blunt dissection via the retractor minimizes potential retraction injury.
• 3D endoscopy combined with a clear retractor enhances surgical corridor safety and monitoring.