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Published on: August 11, 2015
From the Infratentorial to the Supratentorial Compartment with a Minimally Invasive Exoscope-Guided Suboccipital
Giada Garufi1, Alfredo Conti2,3, Domenicantonio Collufio1
1Department of Neurosurgery, Azienda Ospedaliera Papardo, University of Messina, 98158 Messina, Italy.
Background:
Surgical exoscopes represent a significant advancement in neurosurgical procedures, offering enhanced visualization through 3D high-definition digital imaging and superior ergonomics. While their adoption is increasing, the full scope of applications and advantages evident in posterior fossa prone suboccipital approaches remains limited.
Case Description:
We present a detailed technical report of a minimally invasive exoscope-guided suboccipital approach for the resection of a large tentorial meningioma extending into both supra- and infratentorial compartments.
Results:
The exoscope's long working distance and co-axial illumination supported circumferential dissection of the tumor-arachnoid interface with reduced instrument-optics conflict and fewer scope repositioning events. Team visualization via shared display improved coordination during hemostasis and capsule mobilization. The early outcome was favorable; the 18-month MRI (added) showed no residual or recurrence.
Conclusions:
In a prone suboccipital approach, the exoscope enabled stable depth cues in a deep, narrow corridor, minimized optics interference, and enhanced team coordination. These case-specific findings clarify how exoscope features can translate to operative efficiency in posterior fossa surgery while underscoring the need for prospective, comparative, and cost-effectiveness studies.
