Minimally Invasive Brain Port Approach for Accessing Deep-Seated Lesions Using Simple Syringe

Almubarak, Abdulaziz Oqalaa; Alobaid, Abdullah; Qoqandi, Omar; Bafaquh, Mohammed

doi:10.1016/j.wneu.2018.05.236

Cited by 12 publications

(5 citation statements)

References 23 publications

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“…Iatrogenic brain retraction injuries occur in around 10% of major procedures of cranial tumors and 5% of intracerebral aneurysms as previously reported (11)(12)(13)(14)(15). These injuries may range from mild edema to severe edema even contributing to mortality.…”

Section: Discussionmentioning

confidence: 82%

Use of rigid, fixed brain retactors is harmful for the brain

Saad

Khan

Usmani

et al. 2022

LMRJ

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While operating upon the brain, deep seated lesions need to be approached by using retractor’s system, due to the soft and gelatinous nature of the brain. Using a conventional rigid, fixed retractor system for brain retraction appears harmful. As an alternative Thudicam Nasal Speculum (TNS) retractors can be used. This study was aimed to explore the outcome of TNS retractors in brain surgery. The cross-sectional study was conducted at Ziauddin University hospital north campus and National Medical Center Defense, Karachi, Pakistan, during a period between August 2019 to March 2020. A total of 60 patients were included (42 males and 18 females), with a median age of 25 years. In all these cases intra-cranial hematoma were removed with unremarkable damage, in aneurysm clipping it was found useful, without damaging adjacent areas and extraction of brain tumors was found to be very easy and non-damaging to the surrounding brain tissue. Patients had a follow-up period of about 03 months and contusion, ischemia or brain edema was not present in any patient. Only one patient died during second month after surgery due to Ischemic stroke of contra-lateral MCA. The study concludes that using TNS retractors was very helpful and non-damaging to the brain.

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Section: Discussionmentioning

confidence: 82%

Use of rigid, fixed brain retactors is harmful for the brain

Saad

Khan

Usmani

et al. 2022

LMRJ

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“…None of them showed significant rates of intraoperative or postoperative complications. 22 23 24 25 26 We believe that our technique shares the same advantages even with important differences, such as previous dilatation with the Foley probe, which provides security in preventing brain damage and probably less damage to the white matter fibers. Futhermore, our technique did not need an external fixator to secure the retractor, since the flanges of the syringe served as its own retainer.…”

Section: Discussionmentioning

confidence: 86%

“…9 There are reports in the literature of tubular retraction methods with syringes associated with microsurgical techniques such as endoscopy or microscopy, which are used in the resection of lesions such as intracerebral hematomas, glioblastomas, and gliosarcomas, among others (►Table 1). Almubarak et al 22 described a technique similar to ours, in which a retraction system with a syringe and a Foley probe was used, which has been shown to be useful in preventing trauma to the brain parenchyma in the path to the injury. Other articles [23][24][25] have also shown syringe techniques associated with trocar designed from medical-grade plastic dilators or gloves as an alternative.…”

Section: No Complications or Postoperative Morbidity Observedmentioning

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

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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.

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“…Although some surgeons still use open craniotomy through the transcortical-transventricular approach, others favor interhemispheric-transcallosal, endoscopic, or stereotactic aspiration, while many advocate minimally invasive brain ports or brain syringes. [ 2 , 13 , 14 ] With the introduction of CT and MRI, the safety profile of CC removal has significantly improved in recent decades, and the use of less invasive approaches has increased. These and other advanced technologies have also facilitated decision-making and have improved our understanding of the natural history of CC, including the risks of death and neurological deterioration.…”

Section: Discussionmentioning

confidence: 99%

Extensive cerebral venous thrombosis after resection of third ventricle colloid cyst

Kajtazi,

Al Ghamdi,

Al Amoudi

et al. 2023

Surgical Neurology International

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Background: The third ventricle colloid cyst (CC) is a benign growth usually located in the third ventricle and can cause various neurological symptoms, including sudden death. Modern surgical interventions may still result in a wide range of complications and cerebral venous thrombosis (CVT) is among them. Case Description: A 38-year-old female with an existing diagnosis of diabetes mellitus (DM) and hypothyroidism and a 6-month history of headaches, blurred vision, and vomiting presented to our clinic 3 days after the headaches became excessively severe. Neurological examination on admission revealed bilateral papilledema without any associated focal neurological deficits. Brain computed tomography and magnetic resonance imaging confirmed the presence of a third ventricle CC and associated non-communicating hydrocephalus involving the lateral ventricles. As a result, the patient underwent emergency bilateral external ventricular drainage (EVD) insertion followed by a third ventricular CC excision under neuronavigation through a right frontal craniotomy. Twelve days postoperatively, the patient developed further headaches followed by a generalized tonic-clonic seizure that led to no postictal neurological deficits. Nonetheless, computed tomography venography of the brain revealed extensive thrombosis of the superior sagittal sinus, inferior sagittal sinus, right sigmoid sinus, and right internal jugular vein. A newly diagnosed CVT was treated with intravenous heparin. The patient was discharged with warfarin, which was discontinued after 12 months. Ten years after her illness, she remained stable and free from any neurological deficits but still suffered from chronic mild headaches. Conclusion: A preoperative venous study should be performed in all cases to gain a better understanding of the venous anatomy. We advocate meticulous microsurgical techniques to protect the venous system surrounding the foramen of Monro and reduce the amount of retraction during surgery.

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Minimally Invasive Brain Port Approach for Accessing Deep-Seated Lesions Using Simple Syringe

Cited by 12 publications

References 23 publications

Use of rigid, fixed brain retactors is harmful for the brain

Use of rigid, fixed brain retactors is harmful for the brain

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

Extensive cerebral venous thrombosis after resection of third ventricle colloid cyst

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