Multistage Surgical Resection of a Giant Pineal Tumor in an Infant

Opening the Tentorium

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This video segment shows the incision of the tentorium and initial debulking of the tumor.


  • Interhemispheric fissure
  • Falx
  • Tentorium
  • Thulium Laser
  • Internal decompression
  • Ultrasonic surgical aspirator
  • Aspiration
  • Fragmentation

About this video

Giuseppe Cinalli
Matteo Sacco
First online
16 March 2019
Online ISBN
Springer, Cham
Copyright information
© The Author(s) 2019

Video Transcript

Large opening of the tentorium is a very important part of the surgery. We perform the opening with a contact laser fiber with a thulium laser that is able to coagulate and vaporize the tentorium in order to create a very large and effective opening.

After an initial opening of a few millimeters, we are able to access the most superficial and posterior part of the tumor that can be aspirated with the ultrasonic aspirator or with the midpower.

After an initial debulking just to create some space of a maneuver and some bleeding from some vein located on the right side that has been controlled with a self-retaining retractor, we continue the opening of the tentorium with the laser fiber. And these this opening gives access to the tumor located completely below the tentorium. You can see how much the tumor can be seen through the tentorial opening that has been performed with the laser.