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Transcortical Approach to Deep-Seated Intraventricular and Intra-axial Tumors Using a Tubular Retractor System: A Technical Note and Review of the Literature

Lookup NU author(s): Surash Surash


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© 2020 Cambridge University Press. All rights reserved. Background: Retraction of white matter overlying a brain lesion can be difficult without causing significant trauma especially when using traditional methods of bladed retractors. These conventional retractors can produce regions of focal pressure resulting in contusions and areas of infarct. Methods: In this article, we present a retrospective case series of six patients with deep-seated intraventricular and intra-axial tumors that were approached using a ViewSite Brain Access System (tubular retractor). The authors describe a unique method of creating a pathway using a dilated glove. We shall also review the relevant literature that reports this type of surgery. Cases included three cases with third ventricular colloid cysts, one case of a third ventricular arachnoid cyst, one case with a lateral ventricular neurocytoma, and a case with a deeply seated intra-axial metastatic tumor. Results: Gross total resection was achieved in five cases with small residual in the central neurocytoma operation, with no documented neurological deficit in any case. One case had persistent memory problems and one case had continuing decline from the metastatic disease. Conclusion: The introduction of tubular-shaped retractor systems has offered the advantage of reducing retraction pressures and distributing any remaining force in a more even and larger distributed area, thus reducing the risk of previous associated morbidity while also permitting great visualization of the target lesion.

Publication metadata

Author(s): Okasha M, Ineson G, Pesic-Smith J, Surash S

Publication type: Review

Publication status: Published

Journal: Journal of Neurological Surgery, Part A: Central European Neurosurgery

Year: 2021

Volume: 82

Issue: 3

Pages: 270-277

Print publication date: 01/05/2021

Online publication date: 15/12/2020

Acceptance date: 20/12/2020

ISSN (print): 2193-6315

ISSN (electronic): 2193-6323

Publisher: Georg Thieme Verlag


DOI: 10.1055/s-0040-1719025