Pure endoscopic removal of pineal region tumors
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Endoscopic resection of pineal tumors using an endoscope with a mounted rigid suction that allows bimanual handling of the tumor for resection. This contrasts to the established method of biopsy of pineal tumors through intraventricular approach.
Two patients, one with a cystic lesion in the pineal region and one with a large pineal tumor, were operated in sitting position through a subtorcular approach. Endoscope was held in the left hand with suction tip extending beyond the tip through its instrument channel. Regular microsurgical instrumentation/CUSA/Nico Aspirator was used with the right hand for dissection, cutting, and removing the tumor under endoscopic vision.
Surgeon comfort was superior to when microscope is used in sitting position. Complete resection was achieved in all cases.
The two-handed endoscopic technique using a mounted suction on the endoscope as described is a safe and effective strategy for resecting pineal region tumors.
KeywordsPineal tumor Endoscopic surgery Tumor resection
Video legend: Endoscopic subtorcular approach with two-handed technique showing resection of pineal tumor (MPG 15,858 kb)