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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2024; 43(03): e226-e236
DOI: 10.1055/s-0043-1777753
Case Report

Syringe Port System as a Tubular Retractor Technique for Brain Lesions: Case Series and Review of the Literature

Sistema dilatador-seringa como técnica de retração tubular para lesões cerebrais: Série de casos e revisão de literatura
Carlos Augusto Vila Nova Moraes 
1   Department of Neurosurgery, Fundação de Beneficência Hospital de Cirurgia, Aracaju, SE, Brazil
2   Department of Medicine, Universidade Tiradentes, Aracaju, SE, Brazil
,
João Augusto Gama da Sila Neto 
1   Department of Neurosurgery, Fundação de Beneficência Hospital de Cirurgia, Aracaju, SE, Brazil
2   Department of Medicine, Universidade Tiradentes, Aracaju, SE, Brazil
,
Breno William Mariz Guedes 
1   Department of Neurosurgery, Fundação de Beneficência Hospital de Cirurgia, Aracaju, SE, Brazil
,
Arthur Maynart Pereira Oliveira 
1   Department of Neurosurgery, Fundação de Beneficência Hospital de Cirurgia, Aracaju, SE, Brazil
,
Bruno Fernandes de Oliveira Santos 
1   Department of Neurosurgery, Fundação de Beneficência Hospital de Cirurgia, Aracaju, SE, Brazil
2   Department of Medicine, Universidade Tiradentes, Aracaju, SE, Brazil
3   Department of Medicine, Universidade Federal do Sergipe, Aracaju, SE, Brazil
4   Health Sciences Graduate Program, Universidade Federal do Sergipe, Aracaju, SE, Brazil
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Abstract

Objective To describe a tubular retractor technique for brain lesions through a series of cases and to conduct a literature review on intracranial tubular retractors with emphasis on the syringe port system.

Materials and Methods We described four cases of lesions with an intraventricular component and different pathological patterns. The surgeries were performed between April, 2021 and July, 2022. The images were acquired through computed tomography (CT) and magnetic resonance imaging (MRI) scans and transferred to the Horos software, version 1.1.7. To make the tubular retractor, a 20-mL syringe and a 14-Fr/Ch, 30-mL/cc Foley probe were used. The syringe was sectioned according to the planned depth based on preoperative imaging. The syringe was the retractor itself, while the probe served as a means of dilating the path to the lesion.

Results Gross total resection was achieved in all cases, and the samples collected were satisfactory regarding the results of the anatomopathological study. All patients evolved without any additional deficits and with adequate postoperative image control.

Conclusion The syringe as a tubular retractor associated with the Foley probe as a surgical port dilator was useful, and it enabled the radical resection of intracranial tumors related to the lateral ventricle, not limiting the use of auxiliary instruments, neither of microsurgical instruments; therefore, it is an affordable, secure, and inexpensive method.

Resumo

Objetivo Descrever uma técnica de retração tubular para lesões cerebrais por meio de uma série de casos e realizar uma revisão bibliográfica sobre retratores tubulares intracranianos com ênfase no sistema dilatador-seringa.

Materiais e Métodos Foram descritos quatro casos de lesões com componente intraventricular, com diferentes padrões patológicos. As cirurgias foram realizadas entre abril de 2021 e julho de 2022. As imagens foram adquiridas por tomografia computorizada (TC) e ressonância magnética (RM), e transferidas para o programa Horos, versão 1.1.7. Para fabricar o retrator tubular, foram utilizadas uma seringa de 20 mL e uma sonda Foley de 14Fr/Ch, 30mL/cc. A seringa foi seccionada de acordo com a profundidade planejada e com base na imagem pré-operatória. A seringa era o retrator em si, ao passo que a sonda servia como meio de dilatar o caminho para a lesão.

Resultados A ressecção total bruta foi alcançada em todos os casos, e as amostras recolhidas foram satisfatórias com relação aos resultados do estudo anatomopatológico. Todos os pacientes evoluíram sem quaisquer déficits adicionais e com controle de imagem pós-operatório adequado.

Conclusão A seringa como retrator tubular associado à sonda de Foley como dilatador cirúrgico foi útil e permitiu a ressecção radical de tumores intracranianos relacionados com o ventrículo lateral, e não limitou a utilização de instrumentos auxiliares, nem dos instrumentos microcirúrgicos, sendo assim um método acessível, seguro e pouco dispendioso.

Keywords

tubular retractors - brain microsurgery - deep-seated brain lesions - syringe port system

Palavras-chave

retratores tubulares - microcirurgia cerebral - lesões cerebrais profundas - sistema de porta para seringas


Publication History

Received: 20 December 2022

Accepted: 13 September 2023

Article published online:
02 May 2024

© 2024. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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