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Microscopic Resection of Intracranial Lesions with Tubular Retractor of Plastic Syringe: A Single-Center Experience
Mohan Karki1, Manish Vaish1, Yaspal Singh Bundela1
1Department of Neurosurgery, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India.
Objective:
Deeply located intracranial lesions such as intraparenchymal and intraventricular lesions are surgically challenging and associated with unavoidable complications such as seizure, surgical bed hematoma, and brain contusion caused by traction. The objective of this study is to evaluate the safety and effectiveness of the microscopic tubular retractor of a plastic syringe for the resection of deeply located brain lesions.
Materials And Methods:
We retrospectively studied 157 patients with deep-seated intracranial lesions who underwent microscopic resection with the help of a tubular retractor made of a plastic syringe and Teflon introducer between January 2018 and January 2024 in a tertiary hospital. All deep-seated lesions were such as neurocytoma, lymphoma, ependymoma, colloid cysts, metastatic brain tumors, astrocytoma, and meningiomas. We evaluated all patients postoperatively with computed tomography (CT) scan on the first/second day of surgery. The amount of blood loss, the complications, and the mortality rate were recorded.
Results:
There were 104 males and 53 females with a mean age of 54.13 (range: 15-80) years. Gross total resection was obtained in 85.35% and subtotal in 14.65% of patients. Complications such as surgical bed hematoma in 5.73%, seizure in 3.18%, weakness in 2.54%, and contusion in 3.82% of patients were noted. The blood loss varied from 30 to 500 mL (average, 100 mL). The mortality rate was observed in 2.54% of all patients. Follow-up ranged from 1 to 25 months (average, 10 months).
Conclusion:
Plastic syringe tubular retractor with Teflon introducer system is safe and effective for the treatment of deeply located intracranial lesions in terms of low morbidity and excellent rate of resection.
Insights
This study found that a plastic syringe tubular retractor is a safe and effective tool for resecting deep brain lesions. It offers a low complication rate and high success in removing tumors.
Area of Science:
- Neurosurgery
- Minimally Invasive Techniques
- Oncology
Background:
- Deeply located intracranial lesions present significant surgical challenges.
- Traditional approaches risk complications like seizures, hematoma, and brain contusion.
- Novel retractors are needed to improve safety and efficacy.
Purpose of the Study:
- To evaluate the safety and effectiveness of a modified plastic syringe tubular retractor for deep brain lesion resection.
- To assess complication rates and resection success using this innovative tool.
Main Methods:
- Retrospective study of 157 patients with deep-seated intracranial lesions (tumors, cysts) from January 2018 to January 2024.
- Microscopic resection using a tubular retractor fashioned from a plastic syringe and Teflon introducer.
- Postoperative CT scans, blood loss, complication rates, and mortality were recorded.
Main Results:
- Gross total resection achieved in 85.35% of patients; subtotal in 14.65%.
- Low complication rates: surgical bed hematoma (5.73%), seizure (3.18%), weakness (2.54%), contusion (3.82%).
- Average blood loss was 100 mL; mortality rate was 2.54%.
Conclusions:
- The plastic syringe tubular retractor system is a safe and effective option for treating deep intracranial lesions.
- This method demonstrates low morbidity and high resection rates.
- It offers a promising alternative for challenging neurosurgical cases.
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