[Neuroendoscopic Surgery for Intraparenchymal Lesions].

Area of Science:

• Neurosurgery
• Minimally Invasive Techniques
• Neuroendoscopy

Background:

• Deep-seated intraparenchymal brain lesions pose surgical challenges.
• Traditional approaches may involve significant brain tissue manipulation.

Purpose of the Study:

• To evaluate the efficacy and safety of neuroendoscopic surgery using a tubular retractor system (cylinder) for deep-seated intraparenchymal brain lesions.
• To highlight the benefits of combining neuroendoscopy with cylinder retractors for improved visualization and reduced invasiveness.

Main Methods:

• Utilized a tubular retractor system (cylinder) for circumferential force distribution, enabling safe access to deep lesions.
• Integrated neuroendoscopy for enhanced visualization within the narrow surgical corridor.
• Employed multimodal imaging (MRI, CTA, DTI) for preoperative planning.
• Incorporated simulation-based trajectory planning and optimized patient positioning.
• Adapted intraoperative techniques (one/two hands, dry/wet field) based on lesion characteristics.

Main Results:

• The cylinder system allows for safe access to deep-seated lesions with minimal surrounding brain tissue injury.
• Combined neuroendoscopy offers bright, close-up visualization, permitting smaller cylinder diameters and reduced invasiveness.
• Preoperative planning with multimodal imaging and simulation is crucial for defining lesion characteristics and surgical pathways.
• The technique is adaptable for biopsy and selected tumor resections.

Conclusions:

• Neuroendoscopic cylinder surgery is a valuable minimally invasive option for treating intraparenchymal brain lesions.
• Careful case selection and stepwise technical proficiency are key to successful outcomes.
• This approach offers a balance of safety, visualization, and reduced invasiveness for deep brain pathologies.