Modified Park Bench Position for Superior Vermian Arteriovenous Malformations and Dural Fistulas

Motiei-Langroudi, Rouzbeh; Griessenauer, Christoph J.; Alturki, Abdulrahman Y.; Chapman, Paul H.; Ogilvy, Christopher S.; Thomas, Ajith J.

doi:10.1016/j.wneu.2017.06.165

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…However, in our pediatric procedures, the combination of the left ʻhead-upʼ park bench position and adequate illumination enabled successful tumor resection. The modified park bench position has been shown to reduce the incidence of venous air embolism compared to the traditional sitting position 29 . Similar to the sitting position, the modified position uses gravity to separate the tumor from the veins, facilitating tumor dissection without the need for retractors.…”

Section: Discussionmentioning

confidence: 99%

Neurosurgical application of pineal region tumor resection with 3D 4K exoscopy via infratentorial approach: a retrospective cohort study

Hua,

Zhang,

Wang

et al. 2023

International Journal of Surgery

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Background: The pineal region tumors are challenging for neurosurgeons and can lead to secondary hydrocephalus. The advent of the exoscope has provided clinical interventions with high image quality and an ergonomic system for pineal region tumor operations. In this study, we describe the exoscopic approach used to facilitate the surgical resection of pineal region tumors and relieve hydrocephalus. Materials and Methods: In this retrospective cohort study, we consecutively reviewed clinical and radiological data of 25 patients with pineal region lesions who underwent three-dimensional exoscopic tumor resection at a single center. Results: The patient cohort consisted of 16 males and 9 females, with an average age of 34.6 years (range, 6-62 years; 8 cases aged ≤18). Pathological examination confirmed eight pineal gland tumors, four gliomas, nine germ cell neoplasms, two ependymomas, and two metastatic tumors. Preoperative hydrocephalus was present in 23 patients. Prior to tumor resection, external ventricular drainage (EVD) with Ommaya reservoir implantation was performed in 17 patients. Two patients received preoperative endoscopic third ventriculostomy (ETV), and five patients received a ventriculoperitoneal (VP) shunt, including one who received both procedures. Gross total resection was achieved in 19 patients (76%) in the “head-up” park bench position using the exoscope. Eight patients (31.6%) with third ventricle invasion received subtotal resection, mainly in glioma cases, which was higher than those without invasion (0%), but not statistically significant (P=0.278, Fisher’s exact test). No new neurological dysfunction was observed after surgery. Two patients (8%) developed intracranial and pulmonary infections, and two patients (8%) suffered from pneumothorax. Hydrocephalus was significantly relieved in all patients postoperatively, and four patients with relapse hydrocephalus were cured during the long-term follow-up. Postoperative adjuvant management was recommended for indicated patients, and a mean follow-up of 24.8±14.3 months showed a satisfied outcome. Conclusion: The exoscope is a useful tool for pineal region tumor resection and hydrocephalus relief, particularly with posterior third ventricle invasion, as total resection could be achieved without obvious complication. The special superiority of exoscope for indicated pineal region tumors should be highlighted.

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Section: Discussionmentioning

confidence: 99%

Neurosurgical application of pineal region tumor resection with 3D 4K exoscopy via infratentorial approach: a retrospective cohort study

Hua,

Zhang,

Wang

et al. 2023

International Journal of Surgery

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“…Even seemingly small changes in the location of intracranial mass lesions, arteriovenous malformations, and dural fistulas can require a more nuanced trajectory and alterations in patient positioning. As such, modifications of these standard approaches have also emerged in the literature [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Perioperative Positioning in Neurosurgery: A Technical Note on Park Bench Positioning for the Obese Patient Using the “Arrowhead” Technique

Marotta¹,

Brazdzionis²,

Duong³

et al. 2021

Cureus

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Complex neurosurgical procedures, such as those traversing the posterior fossa, require optimization of the operative corridor with advanced patient positioning methods. Even seemingly small changes in the location of intracranial mass lesions can require a more dramatic operative trajectory. Modifications of traditional lateral, semi-sitting, and park-bench approaches have been described in the literature to access these lesions; however, technical considerations with respect to enlarged body habitus have yet to be fully explored. Herein, we describe a technique for positioning obese patients in the park bench position, which is referred to as the “Arrowhead technique,” along with a literature review of positional complications and considerations in the setting of obesity.

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Simplified supine modified park bench / lateral decubitus position using a shoulder pad and a Mayfield head clamp for neurosurgical approach to lesions located in the occipital lobe or the posterior fossa: technical note

Beucler,

Tran,

Dagain

2024

Neurosurg Rev

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Modified Park Bench Position for Superior Vermian Arteriovenous Malformations and Dural Fistulas

Cited by 4 publications

References 20 publications

Neurosurgical application of pineal region tumor resection with 3D 4K exoscopy via infratentorial approach: a retrospective cohort study

Neurosurgical application of pineal region tumor resection with 3D 4K exoscopy via infratentorial approach: a retrospective cohort study

Perioperative Positioning in Neurosurgery: A Technical Note on Park Bench Positioning for the Obese Patient Using the “Arrowhead” Technique

Simplified supine modified park bench / lateral decubitus position using a shoulder pad and a Mayfield head clamp for neurosurgical approach to lesions located in the occipital lobe or the posterior fossa: technical note

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