Minimally Invasive Intradural Tumor Resection

A number of milestones have marked the development of transsphenoidal pituitary tumor resection this century. The introduction of headlamp illumination, followed by the use of the operating microscope and fluoroscopy have allowed neurosurgeons to perform this surgery in a safe and highly effective manner. With the aid of a case report, we describe the incorporation of endoscopic techniques in pituitary tumor resection. The technique described is minimally invasive, avoiding septal dissection and allowing unsurpassed, unobstructed, and panoramic visualization of the region of interest to the surgeon and operative team.

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Primary Calvarial Ewing Sarcoma: A Case Series

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0041-1722900 ◽

2021 ◽

Author(s):

Sandeep Mohindra ◽

Manjul Tripathi ◽

Aman Batish ◽

Ankur Kapoor ◽

Ninad Ramesh Patil ◽

...

Keyword(s):

Ewing Sarcoma ◽

Tumor Resection ◽

Case Series ◽

Radical Excision ◽

Term Outcome ◽

Long Term Outcome ◽

Intradural Tumor ◽

Age Range

Abstract Background Calvarial Ewing tumor is a relatively rare differential among bony neoplasms. We present our experience of managing primary calvarial Ewing sarcoma (EWS), highlighting their clinical and radiological findings. Method In a retrospective analysis, we evaluated our 12-year database for pathologically proven EWS. A literature search was conducted for the comparative presentation and update on the management and outcome. Result From January 2008 to December 2020, we managed eight patients (male:female = 5:3; age range 6 months to 19 years, mean 11.5 years) harboring primary calvarial EWS. All cases underwent wide local excision; two patients required intradural tumor resection, while one required rotation flap for scalp reconstruction. Mean hospital stay was 8 days. All patients received adjuvant chemo- and radiotherapy. Three patients remained asymptomatic at 5 years of follow-up, while two patients died. Conclusion Primary calvarial EWS is a rare entity. It usually affects patients in the first two decades of life. These tumors can be purely intracranial, causing raised intracranial pressure symptoms, which may exhibit rapidly enlarging subgaleal tumors with only cosmetic deformities or symptoms of both. Radical excision followed by adjuvant therapy may offer a favorable long-term outcome.

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Therapy and regeneration-combined bone cements for minimally invasive treatment of neoplastic bone defects

Journal of Materials Chemistry B ◽

10.1039/d1tb00703c ◽

2021 ◽

Author(s):

Yu Qu ◽

Hui Zhuang ◽

Meng Zhang ◽

Yufeng Wang ◽

Dong Zhai ◽

...

Keyword(s):

Calcium Phosphate ◽

Minimally Invasive ◽

Tumor Cells ◽

Bone Tumor ◽

Tumor Resection ◽

Bone Defects ◽

Bone Cements ◽

Invasive Treatment ◽

Calcium Phosphate Cements ◽

Bone Tumor Resection

Although calcium phosphate cements (CPC) have been clinically used to repair bone defects caused by bone tumor resection, traditional CPC cannot kill the remaining tumor cells after surgery and prevent...

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Minimally Invasive Pulmonary Fibroelastoma Resection

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1177/1556984519884308 ◽

2019 ◽

Vol 14 (6) ◽

pp. 577-580 ◽

Cited By ~ 1

Author(s):

Joseph R. Nellis ◽

Charles M. Wojnarski ◽

Zachary W. Fitch ◽

Nicholas A. Andersen ◽

Joseph W. Turek

Keyword(s):

Minimally Invasive ◽

Main Pulmonary Artery ◽

Tumor Resection ◽

Median Sternotomy ◽

Right Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Postoperative Recovery ◽

Pulmonary Valve Replacement ◽

Primary Cardiac Tumor ◽

The Right

Pulmonary fibroelastomas are a rare primary cardiac tumor with less than 50 cases reported in the literature to date. We performed a minimally invasive valve-sparing tumor resection through a left anterior mini-incision (LAMI). The procedure was performed without cardiac arrest or aortic cross clamp, expediting postoperative recovery and allowing for an uncomplicated discharge on postoperative day 5. LAMI is a safe and reliable alternative to median sternotomy for patients requiring interventions on the right ventricular outflow tract and main pulmonary artery, including pulmonary fibroelastoma resection and pulmonary valve replacement when needed.

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Sodium Fluorescein for Spinal Intradural Tumors

Frontiers in Oncology ◽

10.3389/fonc.2020.618579 ◽

2021 ◽

Vol 10 ◽

Author(s):

Semih Kivanc Olguner ◽

Ali Arslan ◽

Vedat Açık ◽

İsmail İstemen ◽

Mehmet Can ◽

...

Keyword(s):

Staining Pattern ◽

Tumor Resection ◽

Sodium Fluorescein ◽

Histopathological Diagnosis ◽

Tumor Surgery ◽

Intramedullary Tumors ◽

Fluorescein Staining ◽

Yellow Filter ◽

Intradural Tumor ◽

Intradural Extramedullary

Technological innovations in spinal intradural tumor surgery simplify treatment. Surgical treatment of cranial benign and malignant pathologies under microscope with sodium (Na)-fluorescein guidance has often been reported, but few studies have focused on spinal intradural tumors. We aimed to investigate the usefulness of Na-fluorescein under yellow filter in intradural spinal tumor surgery by retrospectively reviewing cases involving intramedullary and extramedullary tumors operated under the guidance of Na-fluorescein. Forty-nine adult patients with a diagnosis of spinal intradural tumor operated under a yellow filter (560 nm) microscope using Na-fluorescein dye were included in the study. Demographic data, such as age and sex, neurological status, extent of tumor resection, histopathological diagnosis, Na-fluorescein staining pattern, and its usefulness during surgery were noted and statistically analyzed. Of all recruited patients, 26 women (53.1%) and 23 men (46.9%), were included for analysis. The age range of the patients was 18–64 years, with a mean age of 41.6 ± 13.9. An intradural intramedullary mass was found in 30.6% (n = 15) of the patients, and an intradural extramedullary mass in 69.4% (n: 34). While Na-fluorescein staining was homogeneous in all intradural extramedullary tumors, 73.3% (n: 11) of intradural intramedullary tumors were homogeneous, and 13.3% (n: 2) moderately heterogeneous. In the whole study group, the Na-fluorescein staining pattern was helpful in surgical resection in 47 cases (95.9%). While 34/34 (100%) found it helpful for extramedullary tumors, 13/15 (86.7%) did in intramedullary tumors, and for 2/15 (13.3%) it was not. In conclusion, Na-fluorescein helps in distinguishing tumor from healthy tissue in intradural extramedullary and intramedullary tumor surgery under a yellow filter microscope in most cases, thus providing convenient assistance to surgeons.

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18 Thoracolumbar Metastatic Tumors: Comparison of Minimally Invasive Surgery versus Open Techniques for Addressing Thoracolumbar Metastatic Tumor Resection and Stabilization

Controversies in Spine Surgery: MIS versus OPEN ◽

10.1055/b-0038-149377 ◽

2018 ◽

Keyword(s):

Minimally Invasive Surgery ◽

Minimally Invasive ◽

Invasive Surgery ◽

Tumor Resection ◽

Metastatic Tumor ◽

Metastatic Tumors

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The Rostral Mucosa: The Door to Open and Close for Targeted Endoscopic Endonasal Approaches to the Clivus

Operative Neurosurgery ◽

10.1093/ons/opab141 ◽

2021 ◽

Author(s):

Paolo di Russo ◽

Arianna Fava ◽

Lorenzo Giammattei ◽

Thibault Passeri ◽

Atsushi Okano ◽

...

Keyword(s):

Minimally Invasive ◽

Tumor Resection ◽

Skin Incision ◽

Reconstruction Technique ◽

Endoscopic Endonasal ◽

Invasive Approach ◽

Mucosal Incision ◽

Reconstruction Strategy ◽

Further Development ◽

Targeted Approach

Abstract BACKGROUND Extended endoscopic endonasal approaches (EEAs) have progressively widened the armamentarium of skull base surgeons. In order to reduce approach-related morbidity of EEAs and closure techniques, the development of alternative strategies that minimize the resection of normal tissue and alleviate the use of naso-septal flap (NSF) is needed. We report on a novel targeted approach to the clivus, with incision and closure of the mucosa of the rostrum, as the initial and final step of the approach. OBJECTIVE To present an alternative minimally invasive approach and reconstruction technique for selected clival chordomas. METHODS Three cases of clival chordomas illustrating this technique are provided, together with an operative video. RESULTS The mucosa of the rostrum is incised and elevated from the underlying bone, as first step of surgery. Following tumor resection with angled scope and instruments, the mucosa of the sphenoid sinus (SS) is removed and the tumor cavity and SS are filled with abdominal fat. The mucosal incision of the rostrum is then sutured. A hangman knot is prepared outside the nasal cavity and tightened after the first stitch and a running suture is performed. CONCLUSION We propose, in this preliminary report, a new targeted approach and reconstruction strategy, applying to EEAs the classic concept of skin incision and closure for transcranial approaches. With further development in the instrumentations and visualization tools, this technique may become a valuable minimally invasive endonasal approach for selected lesions.

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