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A stepwise laboratory manual for the dissection and illustration of limbic and paralimbic structures: lessons learned from the Klingler’s technique

  • Teaching Anatomy
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Abstract

Background

Three-dimensional relationships within the limbic and paralimbic areas are often hard to grasp. Relevant anatomical structures exhibit a complicated architecture and connectivity and therefore surgical approaches targeting lesions or functional resections in this area pose a distinct challenge.

Purpose

To provide an educational, comprehensive, systematic and stepwise manual for the dissection and illustration of major limbic structures since there is a gap in the pertinent literature. Further, we aim to offer a thorough yet simplified roadmap for laboratory and intraoperative dissections.

Methods

Twenty (20) normal adult, formalin-fixed cerebral hemispheres were studied through the fiber dissection technique and under the microscope. Stepwise and in tandem medial to lateral and lateral to medial dissections were performed in all specimens aiming to reveal the morphology and spatial relationships of major limbic and paralimbic areas.

Results

Fourteen (14) consecutive, discrete and easily reproducible laboratory anatomical steps are systematically described to reveal the intricate anatomy of the limbic and paralimbic structures and their main connections.

Conclusion

This study offers for the first time in the pertinent literature a focused, step-by-step laboratory manual for the dissection and illustration of the limbic and paralimbic structures. The overreaching goal is to supplement the novice and experienced anatomist and neurosurgeon with a thorough and systematic reference to facilitate laboratory or intraoperative dissections.

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Data availability

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Code availability

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Funding

No funding was received for this study.

Author information

Author notes

  1. Spyridon Komaitis and George Stranjalis contributed equally to the study.

Authors and Affiliations

  1. Athens Microneurosurgery Laboratory, Evangelismos Hospital, Athens, Greece

    Spyridon Komaitis, George Stranjalis, Evangelos Drosos, Aristotelis V. Kalyvas, Georgios P. Skandalakis, Eirini Charalampopoulou & Christos Koutsarnakis

  2. Department of Neurosurgery, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece

    Spyridon Komaitis, George Stranjalis, Evangelos Drosos, Georgios P. Skandalakis, Evangelia Liouta & Christos Koutsarnakis

  3. Edinburgh Microneurosurgery Education Laboratory, Department of Clinical Neurosciences, Western General Hospital, Edinburgh, UK

    Christos Koutsarnakis

  4. Hellenic Center for Neurosurgical Research, “Petros Kokkalis”, Athens, Greece

    Spyridon Komaitis, George Stranjalis, Theodosis Kalamatianos, Evangelos Drosos, Evangelia Liouta & Christos Koutsarnakis

  5. Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada

    Aristotelis V. Kalyvas & Georgios P. Skandalakis

  6. Department of Neurosurgery, Leeds General Infirmary, Leeds, UK

    Nektarios Mazarakis

Authors
  1. Spyridon Komaitis
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  2. George Stranjalis
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  3. Theodosis Kalamatianos
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  4. Evangelos Drosos
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  5. Aristotelis V. Kalyvas
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  6. Georgios P. Skandalakis
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  7. Evangelia Liouta
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  8. Eirini Charalampopoulou
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  9. Nektarios Mazarakis
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  10. Christos Koutsarnakis
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Contributions

Conception and design: SK, GS, TK, CK. Acquisition of data: SK, CK, TK. Analysis and interpretation of data: SK, GPS, TK, CK, AVK, ED, EL, EC, GPS. Drafting the article: SK, CK, TK. Critically revising the article: CK, TK, GPS, SK. Reviewed submitted version of manuscript: all authors. Approved the final version of the manuscript on behalf of all authors: CK. Administrative/technical/material support: SK. Study supervision: SK, GPS, TK.

Corresponding author

Correspondence to Spyridon Komaitis.

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Conflict of interest

The authors report no conflict of interest regarding the materials or methods used in this study or the findings specified in this paper. The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Bioethical Committee of the Medical School of the National and Kapodistrian University of Athens.

Informed consent

This is a cadaveric study not involving patients or patient-related information. All cadaveric specimens used in the current study were obtained by the providing company after strict self-consent or consent from the legally authorized representatives or next of kin of the donors.

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Komaitis, S., Stranjalis, G., Kalamatianos, T. et al. A stepwise laboratory manual for the dissection and illustration of limbic and paralimbic structures: lessons learned from the Klingler’s technique. Surg Radiol Anat 44, 1045–1061 (2022). https://doi.org/10.1007/s00276-022-02981-0

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  • DOI: https://doi.org/10.1007/s00276-022-02981-0

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