Multistage Surgical Resection of a Giant Pineal Tumor in an Infant

Identification of the Sylvian Aqueduct

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In this segment, after removal of the lower pole of the tumor the aqueduct is identified.

Keywords

  • Sylvian aqueduct
  • Midbrain

About this video

Author(s)
Giuseppe Cinalli
Matteo Sacco
First online
16 March 2019
DOI
https://doi.org/10.1007/978-3-030-16006-7_19
Online ISBN
978-3-030-16006-7
Publisher
Springer, Cham
Copyright information
© The Author(s) 2019

Video Transcript

In the end, we arrive to identify the sylvian aqueduct with the electromagnetic navigator. We identify there’s more membrane that separates the surgical cavity from the lowest part or the third ventricle. More membrane is open at this time. And finally, the inlet of the sylvian aqueduct is identified without any possible doubt, with a smooth-hook dissection and is very gentle suction applied at this time, and it is very evident– the inlet of the sylvian aqueduct. And then we proceed anteriorly to identify the cavities of the lateral ventricle.

We still have not opened before now, in a clear way, the whole cavity of the lateral ventricle and finally, with this surgical maneuver, we arrive to identify the choroid plexus and the [? ependyma ?] of the left-lateral ventricle, removing the very last remnant located below the corpus callosum on the left side.

It is very clear. The tumor on the wall that was separating the surgical cavity from the left-lateral ventricle– we can cut and coagulate completely the vessels that separate the tumor from the [? ependyma. ?]

We can cut and remove, [? piecemeal, ?] this pathological tissue that is very easy to identify if compared to the normal neural tissue into the normal ependyma. The vision in the surgical field is excellent at this time without any bleeding, and the possibility to identify without any doubt the pathological tissue from the attachment to the left thalamus is very clear.