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Initial institutional experience using a robotic arm–enabled 4K 3D exoscope in neurosurgical operations

Jawad M. Khalifeh, Ali Karim Ahmed, Wataru Ishida, Joshua Materi, Anita Kalluri, Daniel Lubelski, Timothy Witham, Nicholas Theodore, Debraj Mukherjee, and Judy Huang

: Trigeminal Neuralgia. We present the case of a 77-year-old woman with right-sided sharp, shooting electrical facial pains, consistent with trigeminal neuralgia that is refractory to medical treatment. MRI showed neurovascular conflict with a traversing venous structure abutting the cisternal segment of the right trigeminal nerve. 4:36 Operative Steps: Microvascular Decompression. We performed a right-sided suboccipital retrosigmoid craniectomy, under loupes magnification. Following dural opening, we used the exoscope for the exploration, arachnoid microdissection

Open access

Introduction. Vestibular schwannoma surgery

Michael J. Link, Isaac Yang, Fred G. Barker II, Amir Samii, and Philip V. Theodosopoulos

dealing with VS and rare secondary effects such as hemifacial spasm and trigeminal neuralgia are included. Techniques to deal with cystic tumors, giant tumors, and aberrant anatomy such as a high jugular bulb, making the operation even more difficult, are reviewed. Surgical adjuvants such as the use of endoscopes are also highlighted. Finally, strategies to help deal with tumors related to neurofibromatosis type 2 are included, and hearing rehabilitation options with cochlear implants or auditory brainstem implants are discussed. While some aspects of the operations

Open access

Feasibility of exoscopic keyhole surgery: case series

Miguel Sáez-Alegre, Christian Ríos-Vicil, Keaton Piper, Edinson Najera, and Walter C. Jean

right trigeminal neuralgia refractory both to GKS and medication. The FIESTA MRI sequence showed a loop of the SCA touching the right trigeminal nerve. An MVD through a retrosigmoid craniotomy was performed. In the video, we can see the trigeminal nerve completely thinned, probably due to chronic compression plus GKS. Carefully, the nerve was separated from the SCA loop and a Teflon was placed between these two structures. Patient remains pain free 1 year postoperative on medication. 6:04 The last patient is a 60-year-old female with a left petrous meningioma