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Neurosurgical Review

, Volume 34, Issue 4, pp 457–463 | Cite as

Efficacy of endoport-guided endoscopic resection for deep-seated brain lesions

  • Kwang-Wook Jo
  • Hyung Jin Shin
  • Do-Hyun Nam
  • Jung-Il Lee
  • Kwan Park
  • Jong Hyun Kim
  • Doo-Sik KongEmail author
Original Article

Abstract

Surgery for deep-seated brain lesions without causing significant trauma to the overlying cortex is difficult because brain retraction is required to approach these lesions. The aim of this study was to determine the efficacy of endoport-guided endoscopic or microscopic removal for deep-seated lesions using the neuronavigation system. Between October 2008 and December 2009, 21 patients (17 men and 4 women; average age, 40.8 years) underwent endoport-guided endoscopic tumor removal. We adapted the transparent tubular conduit, so-called “endoport,” to target the lesions under the guidance of neuronavigation. We then determined the efficacy and limitations of this technique with fully endoscopic removal, compared with standard approaches using a spatula retractor. Gross total resection of the lesions was achieved in 14 of 21 patients (66%), and partial removal occurred in four (19%) patients. However, there was failure to remove the lesion through the endoport in three patients (14.3%), requiring the use of blade spatula retractors. In reviewing the seven cases with either failure or partial removal, it was found that a large tumor size (≥3 cm) and calcified lesions were the major factors limiting the application of this technique. Endoport-guided endoscopic surgery facilitated an accurate and minimally invasive technique for removal of these deep-seated brain lesions. This procedure required a protracted learning curve although, when successful, this approach can minimize brain retraction and provide satisfactory visualization.

Keywords

Endoport-guided endoscopy Neuronavigation Intraventricular tumor 

Notes

Acknowledgments

This study was partially supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health & Welfare Affairs, Republic of Korea (A092255), and by the Samsung Biomedical Research Institute grant #SBRI C-B0-303-1.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Kwang-Wook Jo
    • 1
  • Hyung Jin Shin
    • 1
  • Do-Hyun Nam
    • 1
  • Jung-Il Lee
    • 1
  • Kwan Park
    • 1
  • Jong Hyun Kim
    • 1
  • Doo-Sik Kong
    • 1
    Email author
  1. 1.Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan UniversitySchool of MedicineSeoulSouth Korea

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