Multistage Surgical Resection of a Giant Pineal Tumor in an Infant

Identification and Dissection of the Right Vein of Rosenthal

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This segment shows a prolonged dissection of the right vein of Rosenthal.

Keywords

  • Vein of Rosenthal
  • Dissection
  • vein of Galen

About this video

Author(s)
Giuseppe Cinalli
Matteo Sacco
First online
16 March 2019
DOI
https://doi.org/10.1007/978-3-030-16006-7_10
Online ISBN
978-3-030-16006-7
Publisher
Springer, Cham
Copyright information
© The Author(s) 2019

Video Transcript

With identification and dissection of the right vein of Rosenthal, at this point, we continue with the tumor dissection and aspiration. We are not using the Cavitron at this point. And we can identify the right basilar vein of Rosenthal in this image, the left basilar vein of Rosenthal, the vein of Galen in the middle. And we can continue safely our dissection of the tumor [? quadulating ?] and with a piecemeal asportation and removal of the tumor that can be safely cut in the middle with the micro scissors and removed from the posterior fossa.

There is an area of attachment to the right basilar vein of Rosenthal that is well visible at this point. This area is the point where the addition to the venous structure was most dense and was most difficult to dissect. We reduce as much as possible, the mass that is attached to the right vein of Rosenthal, and we dissect the basilar vein of Rosenthal free from the tumor for the longest length that we can achieve with the Rhoton dissector.

You can see here that there is the possibility of removing a good amount of tissue there to the right basilar vein of Rosenthal. Of course, we cannot take too many risks at this level. So considering the very, very large mass of the tumor, and the fact that we still do not have a confirmation of our histology, and we cannot achieve a complete removal in one single step, we decide to leave [INAUDIBLE] to the right basilar vein of Rosenthal and continue our surgery in another way. And we close our patient after hemostasis on a clear surgical field.