Multistage Surgical Resection of a Giant Pineal Tumor in an Infant

Posterior Interhemispheric Transtentorial Approach: Planning and positioning

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This video segment shows a 3D reconstruction of the tumor and discussed surgical planning to be used with neuro-navigation system.

Keywords

  • Surgical planning
  • Surgical position
  • Occipital incision
  • Occipital flap
  • Dural opening

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_2
Online ISBN
978-3-030-16006-7
Publisher
Springer, Cham
Copyright information
© The Author(s) 2019

Video Transcript

So the first surgery was performed through a posterior interhemispheric transtentorial approach. And from position, with the head in a horseshoe head frame in neutral position without flexion, turned 15 degrees to the left to allow right hemisphere to fall due to gravity. Midline occipital incision allowing exposure of the torcular and of the Lambda. Right occipital bone flap crossing the midline and controlling saggital sinus and the right transverse sinus. And the dura open in a U or X fashion.

This is the reconstruction after surgery of the bone flap has been performed. Here is very visible, the Lambda, the saggital sinus, and the right transverse sinus. And you see that the with the flap, you can control both the saggital sinus and the torcular herophili, and the transverse sinus on the right side.