Neurosurgical Technique Novel application of computer-assisted cisternal endoscopy for the biopsy of pineal region tumors: cadaveric study

摘要: Summary Background. Long-standing debate continues about the management and biopsy of pineal tumors because their complex microsurgical anatomy deep location. Inspired by concept under direct visualization in absence hydrocephalus, we explored effectiveness neuroendoscope outside its traditional territory using a new minimally invasive technique, computer-assisted cisternal endoscopy (CACE), for tumors. Method. Five cadaver heads were dissected to expose region through posterior fossa. In other 5 heads, rigid endoscope-wand combination was introduced supracerebellar space lateral arachnoid superior cerebellar cistern midline. Endoscopic exposure gland correlated with real-time image localizing wand. After wand removed, further from veins gland, fourquadrant obtained. Findings. The technologies frameless guided stereotaxy neuroendoscopy enhanced our ability navigate ventriculoscope narrow spaces (e.g., fossa cisterns). Compared transventricular conventional stereotactic trajectories, application CACE infratentorial trajectory offered shortest route region, anatomical orientation, no violation eloquent neurovascular structures, adequate visibility arteries. Conclusions. may be used approach lesions cerebral ventricular system or debulking. Continuous computer updates on endoscope position allows safe navigation cerebrospinal fluid cistern). Its success will await future surgical trials.