Combination of the tubular retractor and brain spatulas provides an adequate operative field in surgery for deep-seated lesions: Case series and technical note

Otani, Yoshihiro; Kurozumi, Kazuhiko; Ishida, Joji; Hiramatsu, Masafumi; Kameda, Masahiro; Ichikawa, Tomotsugu; Date, Isao

doi:10.4103/sni.sni_62_18

Cited by 12 publications

(3 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1 Another well-known commercial model available is the ViewSite (Vycor Medical), which is a clear plastic retractor that also offers the possibility to change the length in 3 different sizes (3 cm, 5 cm and 7 cm) and 4 widths (12 cm, 17 cm, 21 cm, and 28 mm). 10 There is no statistical difference reported in the literature between the different commercial types of tubular retractors regarding the rate of postoperative complications. 11,12 Studies show an equivalence in effectiveness when different types of retractors were compared.…”

Section: Discussionmentioning

confidence: 99%

Syringe Port System as a Tubular Retractor Technique for Brain Lesions: Case Series and Review of the Literature

Moraes,

Neto,

Guedes

et al. 2024

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

View full text Add to dashboard Cite

Objective To describe a tubular retractor technique for brain lesions through a series of cases and to conduct a literature review on intracranial tubular retractors with emphasis on the syringe port system. Materials and Methods We described four cases of lesions with an intraventricular component and different pathological patterns. The surgeries were performed between April, 2021 and July, 2022. The images were acquired through computed tomography (CT) and magnetic resonance imaging (MRI) scans and transferred to the Horos software, version 1.1.7. To make the tubular retractor, a 20-mL syringe and a 14-Fr/Ch, 30-mL/cc Foley probe were used. The syringe was sectioned according to the planned depth based on preoperative imaging. The syringe was the retractor itself, while the probe served as a means of dilating the path to the lesion. Results Gross total resection was achieved in all cases, and the samples collected were satisfactory regarding the results of the anatomopathological study. All patients evolved without any additional deficits and with adequate postoperative image control. Conclusion The syringe as a tubular retractor associated with the Foley probe as a surgical port dilator was useful, and it enabled the radical resection of intracranial tumors related to the lateral ventricle, not limiting the use of auxiliary instruments, neither of microsurgical instruments; therefore, it is an affordable, secure, and inexpensive method.

show abstract

Section: Discussionmentioning

confidence: 99%

Syringe Port System as a Tubular Retractor Technique for Brain Lesions: Case Series and Review of the Literature

Moraes,

Neto,

Guedes

et al. 2024

Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery

View full text Add to dashboard Cite

show abstract

“…The tubular MIA technique has been described in detail, as well as its benefits and utilities. This technique is associated with the use of neuronavigation, tractography and intraoperative monitoring, which makes it an ideal approach to prevent damage as much as possible, achieving an optimal resection rate versus neurological integrity [ 20 , 21 , 22 , 23 ]. A critical aspect that deserves attention is the preoperative assessment of the white matter tracts that will guide the intraoperative neuronavigation phase.…”

Section: Discussionmentioning

confidence: 99%

Standardization of Strategies to Perform a Parafascicular Tubular Approach for the Resection of Brain Tumors in Eloquent Areas

et al. 2023

View full text Add to dashboard Cite

Objective: The aim of this work is to define a methodological strategy for the minimally invasive tubular retractor (MITR) parafascicular transulcal approach (PTA) for the management of brain tumors sited in eloquent areas. Methods: An observational prospective study was designed to evaluate the benefits of PTA associated with MITRs, tractography and intraoperative cortical stimulation. They study was conducted from June 2018 to June 2021. Information regarding white matter tracts was processed, preventing a potential damage during the approach and/or resection. All patients older than 18 years who had a single brain tumor lesion were included in the study. Patients with a preoperative Karnofsky Performance Scale (KPS) score greater than 70% and a Glasgow Coma Scale (GCS) score > 14 points were included. Results: 72 patients were included in the study, the mean age was 49.6, the most affected gender was male, 12.5% presented aphasia, 11.1% presented paraphasia, 41.6% had motor deficit, 9.7% had an affection in the optic pathway, the most frequently affected region was the frontal lobe (26.3%), the most frequent lesions were high-grade gliomas (34.7%) and the measurement of the incisions was on average 5.58 cm. Of the patients, 94.4% underwent a total macroscopic resection and 90.2% did not present new postoperative neurological deficits. In all cases, a PTA was used. Conclusion: Tubular minimally invasive approaches (MIAs) allow one to perform maximal safe resection of brain tumors in eloquent areas, through small surgical corridors. Future comparative studies between traditional and minimally invasive techniques are required to further investigate the potential of these surgical nuances.

show abstract

“…8 Irrespective of approach, the location and anatomical configuration of AIMs require safe navigation through the subcortical space, [9][10][11][12] violation of which can cause postoperative visual, motor, and/or cognitive deficits. 7 Proposed benefits of a tubular, port, or channel-based retractor include the reduction in collateral injury to surrounding white matter tracts, [13][14][15][16][17][18][19][20][21] improved surgeon ergonomics, 22,23 less tissue breach into the surgical field, improved visualization, and versatility when used in adjunct with other approaches and techniques (e.g., endoscopeassisted or fluorescence-guided resection.). [23][24][25] As this is a relatively recent technology, the tumor features lending themselves to selection of channel-based exoscopic surgery for AIMs are not yet well defined.…”

mentioning

confidence: 99%

Tumor characteristics guiding selection of channel-based versus open microscopic approaches for resection of atrial intraventricular meningiomas: patient series

Feng,

Cheok,

Shiroishi

et al. 2023

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

BACKGROUND Atrial intraventricular meningiomas (AIMs) are relatively rare and typically deep-seated tumors that can mandate resection. Compared with transsulcal or transcortical open microscopic approaches, port- or channel-based exoscopic approaches have facilitated a less invasive alternative of tumor access and resection. The authors present a case series of seven patients with AIMs who underwent open microscopic versus channel-based exoscopic resection by a senior neurosurgeon at their institution between 2012 and 2022 to understand patient and tumor features that lent themselves to selection of a particular approach. OBSERVATIONS In the patients harboring three AIMs selected for channel-based resection, the average AIM diameter (2.9 vs 5.2 cm) was smaller, the AIMs were deeper from the cortical surface (2.5 vs 1.1 cm), and the patients had a shorter average postoperative length of stay (3.3 vs 5.8 days) compared with the four patients who underwent open resection. Gross-total resection was achieved in all cases. Complications for both groups included transient homonymous hemianopsia and aphasia. No recurrences were identified over the follow-up period. LESSONS The authors demonstrate that channel-based exoscopic resection is safe and effective for AIMs 3 cm in diameter and over 2 cm deep. This may help guide neurosurgeons in future approach selection based on tumor features, including size/volume, location, and depth from cortical surface.

show abstract

Combination of the tubular retractor and brain spatulas provides an adequate operative field in surgery for deep-seated lesions: Case series and technical note

Cited by 12 publications

References 19 publications

Syringe Port System as a Tubular Retractor Technique for Brain Lesions: Case Series and Review of the Literature

Syringe Port System as a Tubular Retractor Technique for Brain Lesions: Case Series and Review of the Literature

Standardization of Strategies to Perform a Parafascicular Tubular Approach for the Resection of Brain Tumors in Eloquent Areas

Tumor characteristics guiding selection of channel-based versus open microscopic approaches for resection of atrial intraventricular meningiomas: patient series

Contact Info

Product

Resources

About