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Endoscopic Ipsilateral Interhemispheric Approach for Resection of Selected Deep Medial Brain Tumors
Chris McKinnon1, Natalie Voets2, Laurent Livermore1
1Department of Neurosurgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Background:
The interhemispheric fissure provides a natural surgical corridor to access tumors of the deep medial surface of the brain. Conventional microscopic approaches to these tumors are limited by the narrow width of the interhemispheric fissure and need for retraction of brain tissue or traversing overlying cortex. Over the last decade, the endoscope has been used to improve visualization of the operative field in neurosurgery, with benefits in terms of surgical ergonomics and extent of tumor resections. In the context of the interhemispheric fissure, an endoscopic approach may improve visualization of some tumors by providing a brighter, more divergent light source at depth and by enabling the operator to inspect around curved structures (e.g., corpus callosum).
Case Description:
In this report, we present a series of 5 cases with tumors at various locations along the anteroposterior extent of the interhemispheric fissure that were resected using an endoscopic ipsilateral interhemispheric approach.
Conclusions:
The endoscopic ipsilateral interhemispheric approach is an effective and versatile approach to resection of selected deep medial brain tumors extending anteriorly from the genu of the corpus callosum to the splenium. It has notable advantages over the microscope and can be considered a useful adjunct in the surgeon's armamentarium.
Insights
The endoscopic ipsilateral interhemispheric approach offers an effective way to resect deep medial brain tumors. This technique improves visualization and surgical access compared to traditional microscopic methods.
Area of Science:
- Neurosurgery
- Minimally Invasive Techniques
- Brain Tumor Resection
Background:
- The interhemispheric fissure serves as a surgical pathway for deep medial brain tumors.
- Conventional microscopic approaches face limitations due to narrow fissures and brain retraction.
- Endoscopic technology has advanced neurosurgical visualization and resection extent.
Observation:
- A series of 5 cases involving tumors along the interhemispheric fissure were analyzed.
- These tumors were resected using an endoscopic ipsilateral interhemispheric approach.
- Tumor locations spanned from the genu to the splenium of the corpus callosum.
Findings:
- The endoscopic ipsilateral interhemispheric approach provides enhanced visualization with a brighter, more divergent light source.
- It allows for inspection around curved structures like the corpus callosum.
- This method overcomes limitations of narrow fissures and minimizes brain tissue retraction.
Implications:
- The endoscopic ipsilateral interhemispheric approach is effective for selected deep medial brain tumors.
- It offers advantages over traditional microscopic techniques.
- This endoscopic method is a valuable addition to the neurosurgeon's toolkit.
