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

Sascha Marx MD, PhD1,2 and Henry W. S. Schroeder MD, PhD1
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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.
Illustrations from Marx and Schroeder (pp 318–326). Copyright Henry W. S. Schroeder. Published with permission.

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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.

  • 1

    Abdou MS , Cohen AR . Endoscopic treatment of colloid cysts of the third ventricle. Technical note and review of the literature . J Neurosurg . 1998 ;89 (6 ):1062 1068 .

    • Search Google Scholar
    • Export Citation
  • 2

    Wilson DA , Fusco DJ , Wait SD , Nakaji P . Endoscopic resection of colloid cysts: use of a dual-instrument technique and an anterolateral approach . World Neurosurg . 2013 ;80 (5 ):576 583 .

    • Search Google Scholar
    • Export Citation
  • 3

    Boogaarts HD , Decq P , Grotenhuis JA , et al. Long-term results of the neuroendoscopic management of colloid cysts of the third ventricle: a series of 90 cases . Neurosurgery . 2011 ;68 (1 ):179 187 .

    • Search Google Scholar
    • Export Citation
  • 4

    Sethi A , Cavalcante D , Ormond DR . Endoscopic versus microscopic transcallosal excision of colloid cysts: a systematic review in the era of complete endoscopic excision . World Neurosurg . 2019 ;132 :e53 e58 .

    • Search Google Scholar
    • Export Citation
  • 5

    Mathiesen T , Grane P , Lindquist C , von Holst H . High recurrence rate following aspiration of colloid cysts in the third ventricle . J Neurosurg . 1993 ;78 (5 ):748 752 .

    • Search Google Scholar
    • Export Citation
  • 6

    Auer LM , Holzer P , Ascher PW , Heppner F . Endoscopic neurosurgery . Acta Neurochir (Wien) . 1988 ;90 (1-2 ):1 14 .

  • 7

    Lewis AI , Crone KR , Taha J , et al. Surgical resection of third ventricle colloid cysts. Preliminary results comparing transcallosal microsurgery with endoscopy . J Neurosurg . 1994 ;81 (2 ):174 178 .

    • Search Google Scholar
    • Export Citation
  • 8

    Powell MP , Torrens MJ , Thomson JL , Horgan JG . Isodense colloid cysts of the third ventricle: a diagnostic and therapeutic problem resolved by ventriculoscopy . Neurosurgery . 1983 ;13 (3 ):234 237 .

    • Search Google Scholar
    • Export Citation
  • 9

    Sheikh AB , Mendelson ZS , Liu JK . Endoscopic versus microsurgical resection of colloid cysts: a systematic review and meta-analysis of 1,278 patients . World Neurosurg . 2014 ;82 (6 ):1187 1197 .

    • Search Google Scholar
    • Export Citation
  • 10

    Schroeder HW . A new multipurpose ventriculoscope . Neurosurgery . 2008 ;62 (2 ):489 492 .

  • 11

    Oertel J , Linsler S , Csokonay A , et al. Management of severe intraoperative hemorrhage during intraventricular neuroendoscopic procedures: the dry field technique . J Neurosurg . 2018 ;131 (3 ):931 935 .

    • Search Google Scholar
    • Export Citation
  • 12

    Vorbau C , Baldauf J , Oertel J , et al. Long-term results after endoscopic resection of colloid cysts . World Neurosurg . 2019 ;122 :e176 e185 .

    • Search Google Scholar
    • Export Citation
  • 13

    Rangel-Castilla L , Chen F , Choi L , et al. Endoscopic approach to colloid cyst: what is the optimal entry point and trajectory? J Neurosurg . 2014 ;121 (4 ):790 796 .

    • Search Google Scholar
    • Export Citation
  • 14

    Decq P , Le Guerinel C , Brugières P , et al. Endoscopic management of colloid cysts . Neurosurgery . 1998 ;42 (6 ):1288 1296 .

  • 15

    Hellwig D , Bauer BL , Schulte M , et al. Neuroendoscopic treatment for colloid cysts of the third ventricle: the experience of a decade . Neurosurgery . 2003 ;52 (3 ):525 533 .

    • Search Google Scholar
    • Export Citation
  • 16

    Ibáñez-Botella G , Domínguez M , Ros B , et al. Endoscopic transchoroidal and transforaminal approaches for resection of third ventricular colloid cysts . Neurosurg Rev . 2014 ;37 (2 ):227 234 .

    • Search Google Scholar
    • Export Citation
  • 17

    King WA , Ullman JS , Frazee JG , et al. Endoscopic resection of colloid cysts: surgical considerations using the rigid endoscope . Neurosurgery . 1999 ;44 (5 ):1103 1111 .

    • Search Google Scholar
    • Export Citation
  • 18

    Rodziewicz GS , Smith MV , Hodge CJ Jr . Endoscopic colloid cyst surgery . Neurosurgery . 2000 ;46 (3 ):655 662 .

  • 19

    Greenlee JD , Teo C , Ghahreman A , Kwok B . Purely endoscopic resection of colloid cysts . Neurosurgery . 2008 ;62 (3 )(suppl 1 ):51 56 .

    • Search Google Scholar
    • Export Citation
  • 20

    Margetis K , Christos PJ , Souweidane M . Endoscopic resection of incidental colloid cysts . J Neurosurg . 2014 ;120 (6 ):1259 1267 .

    • Search Google Scholar
    • Export Citation
  • 21

    Mishra S , Chandra PS , Suri A , et al. Endoscopic management of third ventricular colloid cysts: eight years’ institutional experience and description of a new technique . Neurol India . 2010 ;58 (3 ):412 417 .

    • Search Google Scholar
    • Export Citation
  • 22

    Sharifi G , Bakhtevari MH , Samadian M , et al. Endoscopic surgery in nonhydrocephalous third ventricular colloid cysts: a feasibility study . World Neurosurg . 2015 ;84 (2 ):398 404 .

    • Search Google Scholar
    • Export Citation
  • 23

    Sribnick EA , Dadashev VY , Miller BA , et al. Neuroendoscopic colloid cyst resection: a case cohort with follow-up and patient satisfaction . World Neurosurg . 2014 ;81 (3-4 ):584 593 .

    • Search Google Scholar
    • Export Citation
  • 24

    Wait SD , Gazzeri R , Wilson DA , et al. Endoscopic colloid cyst resection in the absence of ventriculomegaly . Neurosurgery . 2013 ;73 (1 )(Suppl Operative ):ons39 ons47 .

    • Search Google Scholar
    • Export Citation
  • 25

    Chibbaro S , Champeaux C , Poczos P , et al. Anterior trans-frontal endoscopic management of colloid cyst: an effective, safe, and elegant way of treatment. Case series and technical note from a multicenter prospective study . Neurosurg Rev . 2014 ;37 (2 ):235 241 .

    • Search Google Scholar
    • Export Citation
  • 26

    Delitala A , Brunori A , Russo N . Supraorbital endoscopic approach to colloid cysts . Neurosurgery . 2011 ;69 (2 )(Suppl Operative ):ons176 ons183 .

    • Search Google Scholar
    • Export Citation
  • 27

    Harris AE , Hadjipanayis CG , Lunsford LD , et al. Microsurgical removal of intraventricular lesions using endoscopic visualization and stereotactic guidance . Neurosurgery . 2005 ;56 (1 )(suppl ):125 132 .

    • Search Google Scholar
    • Export Citation
  • 28

    Horn EM , Feiz-Erfan I , Bristol RE , et al. Treatment options for third ventricular colloid cysts: comparison of open microsurgical versus endoscopic resection . Neurosurgery . 2007 ;60 (4 ):613 620 .

    • Search Google Scholar
    • Export Citation
  • 29

    Sabanci PA , Aras Y , Ali A , et al. Transcortical removal of third ventricular colloid cysts: comparison of conventional, guided microsurgical and endoscopic approaches and review of the literature . Turk Neurosurg . 2017 ;27 (4 ):546 557 .

    • Search Google Scholar
    • Export Citation
  • 30

    Hoffman CE , Savage NJ , Souweidane MM . The significance of cyst remnants after endoscopic colloid cyst resection: a retrospective clinical case series . Neurosurgery . 2013 ;73 (2 ):233 239 .

    • Search Google Scholar
    • Export Citation
  • 31

    Manwaring JC , El Damaty A , Baldauf J , Schroeder HW . The small-chamber irrigation technique (SCIT): a simple maneuver for managing intraoperative hemorrhage during endoscopic intraventricular surgery . Neurosurgery . 2014 ;10 (suppl 3 ):375 379 .

    • Search Google Scholar
    • Export Citation
  • 32

    Tawk RG , Akinduro OO , Grewal SS , et al. Endoscopic transforaminal transchoroidal approach to the third ventricle for cystic and solid tumors . World Neurosurg . 2020 ;134 :e453 e459 .

    • Search Google Scholar
    • Export Citation

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