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Acta Neurochirurgica

, Volume 155, Issue 1, pp 135–138 | Cite as

Evolving instrumentation for endoscopic tumour removal of CNS tumours

  • Senthil K. SelvanathanEmail author
  • Ramesh Kumar
  • John Goodden
  • Atul Tyagi
  • Paul Chumas
Technical Note - Neurosurgical Techniques

Abstract

Background

Open surgical approaches to intraventricular tumours are complex and challenging. Neuro-endoscopy, however, has enabled us to biopsy and resect small intraventricular tumours with potentially reduced morbidity. Nevertheless, suitable methods/ instrumentation for resection have limited the use of the endoscope. The authors report the utilisation of endoscopic ultrasonic aspirator in the resection of an intraventricular tumour. This technique was compared to another case that utilised conventional endoscopic techniques for removal of an intraventricular tumour.

Methods

Using an endoscope, the third ventricle was entered and visualised, with the tumours clearly seen. Tumours were then either debulked via conventional or novel technique.

Results

Using the conventional technique, tumour was removed with rongeurs via the flexible scope. Irrigation was needed to improve vision due to bleeding. Postoperative magnetic resonance imaging (MRI) confirmed good excision. Histology was reported as anaplastic ependymoma World Health Organization (WHO) Grade III. Utilising the novel technique, the tumour was also debulked uneventfully. Histology confirmed Grade 1 glioneuronal tumour. Postoperative MRI revealed a small residuum.

Conclusions

To date, endoscopic resection of tumours has been limited by suitable tools. The advent of an ultrasonic aspirator that can be used down an endoscope increases the possibilities for such resections. This is the first reported case of endoscopic resection of an intraventricular tumour using this technique.

Keywords

Aqueduct of Sylvius tumour Endoscopic ultrasonic aspirator Neuroendoscopy 

Notes

Disclosures

No funding received.

Conflicts of interest

None.

Supplementary material

ESM 1

(MPG 7896 kb)

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Copyright information

© Springer-Verlag Wien 2012

Authors and Affiliations

  • Senthil K. Selvanathan
    • 1
    Email author
  • Ramesh Kumar
    • 1
  • John Goodden
    • 1
  • Atul Tyagi
    • 1
  • Paul Chumas
    • 1
  1. 1.Department of NeurosurgeryLeeds General InfirmaryLeedsUnited Kingdom

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