scholarly journals Surgical Techniques to Preserve the Bridging Veins in Interhemispheric Approach(Interhemispheric Approach)

1992 ◽  
Vol 1 (3) ◽  
pp. 196-200 ◽  
Author(s):  
Takeshi Sampei ◽  
Nobuyuki Yasui
Keyword(s):  
Surgical Techniques ◽  
Interhemispheric Approach ◽  
Bridging Veins

scholarly journals Mapping and anatomo-surgical techniques for SMA-cingulum-corpus callosum gliomas; how I do it

2021 ◽  
Author(s):  
Dimitris Klitsinikos ◽  
Justyna O. Ekert ◽  
Annefloor Carels ◽  
George Samandouras
Keyword(s):  
Corpus Callosum ◽  
Vascular Injury ◽  
Brain Mapping ◽  
Cognitive Functions ◽  
Early Identification ◽  
Surgical Techniques ◽  
Interhemispheric Approach ◽  
Full Protection

Abstract Background Awake brain mapping paradigms are variable, particularly in SMA, and not personalised to each patient. In addition, subpial resections do not offer full protection to vascular injury, as the pia can be easily violated. Methods Mapping paradigms developed by a multidisciplinary brain mapping team. During resection, a combined subpial/interhemispheric approach allowed early identification and arterial skeletonization. Precise anatomo-surgical dissection of the affected cingulum and corpus callosum was achieved. Conclusions In SMA-cingulum-CC tumours, a combined subpial/interhemispheric approach reduces risk of vascular injury allowing precise anatomo-surgical dissections. Knowledge of cognitive functions of affected parcels is likely to offer best outcomes.

Significance of preserving bridging veins in an interhemispheric approach

1990 ◽  
Vol 33 (2) ◽  
pp. 159-160 ◽  
Author(s):  
Nobuhiko Aoki ◽  
Tatsuo Sakai ◽  
Akihiro Oikawa ◽  
Kazuo Tsutsumi
Keyword(s):  
Interhemispheric Approach ◽  
Bridging Veins

Venous infarction following the interhemispheric approach in patients with acute subarachnoid hemorrhage

1991 ◽  
Vol 74 (5) ◽  
pp. 715-729 ◽  
Author(s):  
Kazuo Tsutsumi ◽  
Yoshiaki Shiokawa ◽  
Tatsuo Sakai ◽  
Nobuhiko Aoki ◽  
Masaru Kubota ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Venous Drainage ◽  
Acute Stage ◽  
Anterior Communicating Artery ◽  
Aneurysm Surgery ◽  
Venous Infarction ◽  
Content Type ◽  
Interhemispheric Approach ◽  
Acute Subarachnoid Hemorrhage ◽  
Bridging Veins

✓ Postoperative venous infarction following aneurysm surgery was studied in 48 patients with anterior communicating artery aneurysms operated on through the interhemispheric approach at the acute stage of subarachnoid hemorrhage (SAH). Of 23 patients whose bridging veins were sacrificed during surgery, 11 (47.8%) showed venous infarction in the frontal lobes. In contrast, only one (5.9%) of 17 patients whose bridging veins were preserved developed cerebral edema. None of eight patients who were operated on after Day 11 (the day of SAH was defined as Day 0) showed this complication, although bridging veins were sacrificed in six of them. Venous infarction following acute aneurysm surgery tended to occur more frequently in patients of higher SAH grade and/or more advanced age, but these correlations were not significant. However, the correlation between the sacrifice of veins and venous infarction was significant (p < 0.025). Because this potential complication may compromise the benefit of acute aneurysm surgery and cause damage, it is important to preserve the venous system and in some instances to select another surgical approach based on the pattern of venous drainage in the frontal lobe.

Anterior Interhemispheric Approach for 100 Tumors in and Around the Anterior Third Ventricle

2010 ◽  
Vol 66 (suppl_1) ◽  
pp. ons-65-ons-74 ◽  
Author(s):  
Tomokatsu Hori ◽  
Takakazu Kawamata ◽  
Kosaku Amano ◽  
Yasuo Aihara ◽  
Masami Ono ◽  
...  
Keyword(s):  
Third Ventricle ◽  
Karnofsky Performance Scale ◽  
Subtotal Resection ◽  
Anterior Communicating Artery ◽  
Lamina Terminalis ◽  
Interhemispheric Approach ◽  
Anterior Interhemispheric Approach ◽  
Bridging Veins ◽  
Performance Scale

Abstract Objective: We report our experience with anterior interhemispheric approach for tumors in and around the anterior third ventricle, including surgical technique, instrumentation, pre- and postoperative hormonal disturbances, and resection rate. Methods: One hundred patients with 46 craniopharyngiomas, 12 hypothalamic gliomas, 12 meningiomas, 6 hypothalamic hamartomas, and 24 other lesions were operated on using an anterior interhemispheric approach with or without opening of the lamina terminalis. This surgical approach involves no frontal sinus opening; a narrow (approximately 15–20 mm in width) access between the bridging veins, which is sufficient to remove the tumor totally; and sparing of the anterior communicating artery. Specially designed long bipolar forceps and scissors are necessary for this approach, and concomitant use of angled instruments (endoscope, aspirator, and microforceps) is required frequently. The postsurgical follow-up period varied from 4 months to 18 years. Results: Total removal of the neoplasm was accomplished in 37 of 46 patients with craniopharyngiomas (80.4%), whereas subtotal resection was performed in hypothalamic gliomas. No significant differences in pre- and postoperative hormonal disturbances were observed in 37 craniopharyngiomas and 10 hypothalamic gliomas. There was no operative mortality. Visual acuity was preserved or improved in 68 of 75 patients assessed. The Karnofsky Performance Scale score did not deteriorate in 72 of 75 patients tested. Conclusion: The minimally invasive anterior interhemispheric approach, with or without opening of the lamina terminalis, is useful for removal of tumors in and around the anterior third ventricle, such as craniopharyngiomas and hypothalamic gliomas.

Basal interfalcine approach through a frontal sinusotomy with vein and nerve preservation

1994 ◽  
Vol 80 (3) ◽  
pp. 575-579 ◽  
Author(s):  
Kazuhiko Fujitsu ◽  
Tsunemi Sekino ◽  
Katsumi Sakata ◽  
Takashi Kawasaki
Keyword(s):  
Third Ventricle ◽  
Surgical Techniques ◽  
Frontal Bone ◽  
Anterior Communicating Artery ◽  
Content Type ◽  
Nerve Preservation ◽  
The Third ◽  
Basal Portion ◽  
Bridging Veins ◽  
Interhemispheric Fissure

✓ The authors describe a new method for a frontal interhemispheric approach when treating craniopharyngiomas of the third ventricle or anterior communicating artery aneurysms. This technique ensures preservation of the bridging veins and the olfactory nerves. This “basal interfalcine approach” involves a craniotomy in the centrobasal portion of the frontal bone (the frontal sinus), removal of the inner tables and the crista galli, and splitting the basal portion of the falx into two leaves, through which the basal interhemispheric fissure is opened. The olfactory nerves are protected by the leaves of the falx, and the bridging veins are preserved because the approach is low enough to spare them. The surgical techniques are described together with a unilateral variation of this approach. The significance of preserving the bridging veins is discussed in connection with avoidance of postoperative contusional hemorrhage.

Bifrontal basal interhemispheric approach to craniopharyngioma resection with or without division of the anterior communicating artery

1996 ◽  
Vol 84 (6) ◽  
pp. 951-956 ◽  
Author(s):  
Masato Shibuya ◽  
Masakazu Takayasu ◽  
Yoshio Suzuki ◽  
Kiyoshi Saito ◽  
Kenichiro Sugita
Keyword(s):  
Late Complications ◽  
Pituitary Stalk ◽  
Anterior Communicating Artery ◽  
Operative Field ◽  
Content Type ◽  
Visual Improvement ◽  
Interhemispheric Approach ◽  
Anterior Interhemispheric Approach ◽  
Bridging Veins ◽  
Perforating Arteries

✓ The authors describe the use of a bifrontal basal interhemispheric approach with or without division of the anterior communicating artery (ACoA) for removal of large craniopharyngiomas. This approach is a more basal modification of the anterior interhemispheric approach, allowing preservation of most bridging veins. Since 1988, 22 patients underwent operations using this approach to achieve total or near-total excision of large craniopharyngiomas. Division of the ACoA was performed in 11 of 17 patients with retrochiasmatic tumors with no early or late complications related to division of the artery. There were no operative mortalities. Visual improvement (59%) and preservation of the pituitary stalk (64%) were achieved in a high percentage of patients. Preservation of the pituitary stalk correlated well with postoperative pituitary function. The bifrontal basal interhemispheric approach allowed a bilateral, wider operative field with better orientation and views of important neural structures and perforating arteries without requiring combination with other approaches. When the ACoA limited operative exposure, the artery could be divided safely. The authors discuss indications for, and advantages of, the bifrontal basal interhemispheric approach with or without division of the ACoA in the removal of large craniopharyngiomas.

Surgical Techniques in the Treatment of Pancreatic Pseudocysts

Swiss Surgery ◽  
2003 ◽  
Vol 9 (3) ◽  
pp. 131-134
Author(s):  
Röthlin
Keyword(s):  
Surgical Techniques ◽  
Pancreatic Pseudocysts

Anhand der Pseudozysteneinteilung nach D'Egidio und Schein werden die verschiedenen chirurgischen Techniken der Pseudozystendrainage und -resektion diskutiert. Die Möglichkeiten und Grenzen der laparoskopischen Technik werden dargestellt. Auf die "Konkurrenz" der endoskopischen und interventionellen Therapien wird lediglich am Rand verwiesen. Prognostisch hängt der weitere Verlauf nach Pseudozystenoperation weniger von der Operationstechnik, als vom natürlichen Verlauf der Erkrankung (chron. Pankreatitis) und vom Sistieren, bzw. Weiterbestehen der zugrundeliegenden Noxe ab.

Current Strategies in the Management of Spinal Metastatic Disease

Swiss Surgery ◽  
2003 ◽  
Vol 9 (2) ◽  
pp. 55-62 ◽  
Author(s):  
Bartanusz ◽  
Porchet
Keyword(s):  
Spinal Cord ◽  
Surgical Techniques ◽  
Cord Compression ◽  
Treatment Modalities ◽  
Surgical Approaches ◽  
Spinal Stabilization ◽  
Management Algorithm ◽  
Specific Manner ◽  
Extensive Surgery ◽  
Selection Of

The treatment of metastatic spinal cord compression is complex. The three treatment modalities that are currently applied (in a histologically non-specific manner) are surgery, radiotherapy and the administration of steroids. The development of new spinal instrumentations and surgical approaches considerably changed the extent of therapeutic options in this field. These new surgical techniques have made it possible to resect these tumours totally, with subsequent vertebral reconstruction and spinal stabilization. In this respect, it is important to clearly identify those patients who can benefit from such an extensive surgery. We present our management algorithm to help select patients for surgery and at the same time identifying those for whom primary non-surgical therapy would be indicated. The retrospective review of surgically treated patients in our department in the last four years reveals a meagre application of conventional guidelines for the selection of the appropriate operative approach in the surgical management of these patients. The reasons for this discrepancy are discussed.

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