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DOI: 10.1055/s-2003-40740
A Minimally Invasive Approach to Deep-Seated Brain Lesions Using Balloon Dilatation and Ultrasound Guidance
Publikationsverlauf
Publikationsdatum:
21. Juli 2003 (online)
![](https://www.thieme-connect.de/media/min/200303/lookinside/thumbnails/10.1055-s-2003-40740-1.jpg)
Abstract
Conventional dissection techniques require the excision of a channel from the cortex through the white matter with suction and bipolar cautery for the excision of deep-seated brain lesions. An alternative approach, using a previously described technique, in four cases is illustrated in this article. After craniotomy and dural opening, the index finger portion of a surgical glove was removed, tied over a brain cannula and gently passed towards the lesion under ultrasound guidance. Once the needle-tip was sonologically confirmed to be on the lesion, the balloon was inflated with about 3 to 5 ml of saline. This created a track through which the lesion could be excised under the microscope. The lesions were satisfactorily excised through the track created without removal of brain tissue. The accuracy of this minimally invasive technique can be enhanced when used in conjunction with intraoperative ultrasound guidance.
Key words
Balloon dilatation - minimally invasive neurosurgery - intraoperative ultrasound - deep brain lesions
References
- 1 Shahbabian S, Keller J T, Gould III H J, Dunsker S B, Mayfield F H. A new technique for making cortical incisions with minimal damage to cerebral tissue. Surg Neurol. 1983; 20 310-312
- 2 Madrazo I, Franco-Bourland R, Aguilera M, Reyes P, Guizar-Sahagun G. Balloon needle for the atraumatic transcortical ventricular approach: Technical note. Surg Neurol. 1990; 33 226-227
- 3 Hirsch J F, Sainte-Rose C. A new surgical approach to subcortical lesions: balloon inflation and cortical gluing. Technical note. J Neurosurg. 1991; 74 1014-1017
- 4 Yasargil M G, Cravens G F, Roth P. Surgical approaches to inaccessible tumors. Clin Neurosurg. 1988; 34 42-110
- 5 Apuzzo M L, Sabshin J K. Computed tomographic guidance stereotaxis in the management of intracranial mass lesions. Neurosurgery. 1983; 12 277-285
- 6 Barnett G H, Kormos D W, Steiner C P, Weisenberger J. Intraoperative localization using an armless, frameless stereotactic wand: technical note. J Neurosurg. 1993; 78 510-514
- 7 Golfinos J G, Fitzpatrick B C, Lawrence R S, Spetzler R F. Clinical use of a frameless stereotactic arm: results of 325 cases. J Neurosurg. 1984; 28 792-800
- 8 Roberts D W, Strohbein J W, Hatch J F, Murray W, Kettenberger H. A frameless stereotactic integration of computerized imaging and the operating microscope. J Neurosurg. 1986; 65 545-549
- 9 Zinreich J S, Tebo S A. Frameless stereotactic integration of CT imaging data: accuracy and initial applications. Radiology. 1993; 188 735-743
- 10 Rubin J M, Quint D. Intraoperative US versus intraoperative MR imaging for guidance during intracranial neurosurgery. Radiology. 2000; 215 917-918
A. G. Chacko,M. Ch.
Section of Neurosurgery · Christian Medical College Hospital
Vellore 632004
India
Fax: +91-416-2232103
eMail: agchacko@cmcvellore.ac.in