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Tailored Callosotomy Guided by Neuronavigated Autofocus Microscope for Interhemispheric Transcallosal Approach to

Luca Campagnaro¹, Camilla Bonaudo², Shani Don Enderage¹

¹Neurosurgical Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health - Careggi University Hospital, Florence, Italy.

World Neurosurgery

|December 28, 2025

Summary

This summary is machine-generated.

This study introduces a neuronavigated autofocus microscope (NAM)-guided strategy for the interhemispheric transcallosal route (IHTCR). The technique enables smaller callosotomies, minimizing the risk of disconnection syndrome during intraventricular lesion resection.

Keywords:

Callosotomy Interhemispheric transcallosal approach Intraventricular lesions Neuronavigated autofocus microscope

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Area of Science:

Neurosurgery
Medical Technology
Neuroanatomy

Background:

The interhemispheric transcallosal route (IHTCR) is utilized for intraventricular lesions but carries risks like disconnection syndrome.
Minimizing callosotomy size, particularly avoiding the middle/posterior corpus callosum (CC), is crucial to reduce morbidity.
Limited literature exists on neuronavigation for tailored IHTCR.

Purpose of the Study:

To describe the technical nuances of a neuronavigated autofocus microscope (NAM)-guided strategy for IHTCR.
To report the outcomes regarding callosotomy size in patients undergoing IHTCR for intraventricular lesions.

Main Methods:

Retrospective review of eight consecutive patients undergoing IHTCR guided by NAM.
Detailed reporting of surgical planning and intraoperative neuronavigated images.
Focus on callosotomy location and size relative to tumor dimensions.

Main Results:

Callosal sections were consistently located in the anterior third of the CC body.
Callosotomy size was small (<8 mm for small lesions, <20 mm for large lesions), often less than half the tumor diameter.
All patients showed symptom improvement post-surgery with no signs of disconnection syndrome.

Conclusions:

The NAM-guided strategy allows for a customized IHTCR approach.
This technique facilitates surgical procedures and achieves significantly smaller callosotomies.
The approach enhances patient outcomes by minimizing morbidity associated with IHTCR.