Endoscopic bimanual sharp dissection technique for gross-total resection of colloid cysts: technical note

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  • 1 Department of Neurosurgery, University Medicine Greifswald, Germany; and
  • 2 Department of Cancer Immunology and Virology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts
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Neuroendoscopic resection of colloid cysts has gained tremendous popularity over the last 2 decades because of good clinical outcomes and a low complication profile. However, in comparison to microsurgical resections, endoscopic resection has a lower rate of gross-total resection, which leaves the patient at risk for cyst recurrence. At present, there is still ongoing debate as to the best surgical approach for colloid cysts. Endoscopic resection as a technique has to compete with the good outcomes of microsurgical resections with respect to a long-term recurrence-free outcome. It is the authors’ belief that gross-total resection should be the aim of endoscopic cyst resection. In this technical note, they describe their surgical technique for achieving safe gross-total resection of colloid cysts by using a ventriculoscopic system. The surgical technique includes a far anterolateral entry point, navigational guidance, bimanual sharp dissection, use of the endoscopic sheath as a retractor, the small-chamber irrigation technique, and the dry-field technique for hemostasis.

ABBREVIATIONS GTR = gross-total resection.

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Contributor Notes

Correspondence Sascha Marx: University Medicine Greifswald, Germany. marxs@uni-greifswald.de.

INCLUDE WHEN CITING Published online September 11, 2020; DOI: 10.3171/2020.5.JNS201583.

Disclosures Dr. Schroeder is a consultant for Karl Storz SE & Co. KG.

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