Abstract
Objective and importance
We describe a new endoscopic technique, the dual-endoscopic method, in which two independent endoscopic systems are simultaneously used in the subtemporal space and intraparenchymal field for patients with pontine cystic tumours. Tumours were successfully removed through a sheath placed in the brainstem via the subtemporal keyhole approach, with safety ensured by the second subtemporal endoscope.
Clinical presentation
A purely endoscopic subtemporal approach was performed in three cases of pontine cystic tumour, including two low-grade gliomas and a recurrent chordoma. The gliomas showed nodules. Recurrent chordoma consisted of a mucinous component.
Technique
Using a keyhole subtemporal approach and a 4.0-mm rigid endoscope with a high-definition camera, a transparent puncture needle containing a 2.7-mm rigid endoscope was inserted into the cyst. The tumour was removed using suction, biopsy forceps, and scissors simultaneously placed with the 2.7-mm endoscope in a transparent sheath.
Conclusion
Since the 4.0-mm endoscope placed in the subtemporal space monitored all procedures of the 2.7-mm endoscope, tumour removal was performed safely without damaging the pons, cranial nerves, or vessels. We safely and successfully removed a cystic pontine tumour using a dual-endoscopic method. This new method ensures the safety of deep-seated endoscopic procedures via a minimally invasive transcranial approach.
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Acknowledgments
The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
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No funding sources were involved in the present study.
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Watanabe, T., Sato, T., Kishida, Y. et al. Endoscopic resection of cystic pontine tumour: three case reports and a proposal for minimally invasive dual-endoscopic surgery. Acta Neurochir 156, 1145–1150 (2014). https://doi.org/10.1007/s00701-014-2085-x
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DOI: https://doi.org/10.1007/s00701-014-2085-x