Microsurgical Fenestration of Thalamic Cyst Along With Third Ventriculostomy and Septal Fenestration via the Interhemispheric Transcallosal Approach: 3-Dimensional Operative Video

A Novel Foley Catheter-Based Brain Retraction Method for the Interhemispheric Approach: Technical Considerations and an Illustrative Video

BACKGROUND

Management of interhemispheric pathologies requires surgical intervention through a restricted anatomical corridor ensconced within critical cerebral structures. The use of retractors to facilitate operative access may cause damage to cerebral tissue. The development of an innovative retraction technique designed to alleviate cerebral damage in such cases is imperative. In this study, we present a novel and gentle retraction method to facilitate the interhemisferic approach.

METHODS

We retrospectively examined data of 9 right-handed patients who underwent surgical resection of interhemispheric lesions between 2021 and 2022. All patients underwent surgery for the first time because of this pathology. All operative specimens were histologically confirmed. Clinical characteristics, operative details, and follow-up data were retrospectively analyzed.

RESULTS

The new retraction technique was successfully applied to 8 tumor patients and 1 patient with an aneurysm. Eight patients had an anterior interhemispheric approach, and 1 patient had a posterior interhemispheric approach. Complete surgical excision was achieved in all patients with no postoperative complications. Postoperative Gadolinium (Gd)-enhanced magnetic resonance imaging (MRI) showed no signs of ischemia or contusion. All patients exhibited significant improvements in their symptoms. An illustrative video that elucidates the removal of an interhemispheric epidermoid tumor, employing the anterior ipsilateral interhemispheric approach, featuring the novel retraction method.

CONCLUSIONS

The ideal retraction technique during the interhemispheric approach is still a challenge. Our novel retraction technique may help minimize brain parenchymal damage during surgical resection of interhemispheric lesions.

Step-by-Step Guide on How to Make a 2-Dimensional Operative Neurosurgical Video: Microsurgical Resection of a Right Lateral Ventricle Subependymoma by an Anterior Interhemispheric Transcallosal Approach

BACKGROUND

Digital video recordings are increasingly used across various medical and surgical disciplines with advances in computer hardware and software technologies. The creation of high-quality surgical video footage requires a basic understanding of key technical considerations, together with creativity and sound aesthetic judgment. Online operative videos have become a core resource within neurosurgical education.

OBJECTIVE

To provide a step-by-step description for making operative videos using a video from a real case as an example.

METHODS

We recorded an operative video of the microsurgical resection of a right lateral ventricle subependymoma performed by an anterior interhemispheric transcallosal approach. The patient consented to surgical resection of the subependymoma and to publication of this operative video. With the video, we explain the step-by-step process the authors used for developing the raw video into a publishable surgical video.

RESULTS

The patient depicted in our video tolerated the surgery well and made a complete recovery. The final video produced from the surgery illustrated elements that Operative Neurosurgery, Neurosurgery, and other journals require in surgical videos.

CONCLUSION

Although more than 1200 peer-reviewed (PubMed) neurosurgical operative videos have been published so far, there has not been a single publication that describes the step-by-step process of producing an operative video. To the best of our knowledge, this is the first published detailed description of editing of an educational operative video in neurosurgery and the first video case report of a microsurgical resection of subependymoma of the lateral ventricle in the peer-reviewed English literature.