Minimally invasive endoscopic transventricular hemispherotomy for medically intractable epilepsy: A new approach and cadaveric demonstration - Laboratory investigation

Biji Bahuleyan, Sunil Manjila, Shenandoah Robinson, Alan Cohen

Research output: Contribution to journalArticle

Abstract

Object. Surgery for medically intractable epilepsy secondary to unihemispheric pathology has evolved from more aggressive hemispherectomy to less aggressive variations of hemispherotomy. The authors propose a novel minimally invasive endoscopic hemispherotomy that should give results comparable to conventional open craniotomy and microsurgery. Methods. Endoscopic transventricular hemispherotomy was performed in 5 silicon-injected cadaveric heads in the authors' minimally invasive neurosurgery laboratory. The lateral ventricle was accessed endoscopically through a frontal and occipital bur hole. White matter disconnections were performed to unroof the temporal horn and to disconnect the frontobasal region, corpus callosum, and fornix. Results. Using an endoscopic transventricular approach, all white matter disconnections were successfully performed in all 5 cadavers. Conclusions. The authors have demonstrated the feasibility of endoscopic transventricular hemispherotomy in a cadaveric model. The technique is simple and could be useful in a subgroup of patients with parenchymal volume loss and ventriculomegaly.

Original languageEnglish (US)
Pages (from-to)536-540
Number of pages5
JournalJournal of Neurosurgery: Pediatrics
Volume6
Issue number6
DOIs
Publication statusPublished - Dec 2010
Externally publishedYes

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Keywords

  • Endoscopic anatomy
  • Epilepsy
  • Hemispherotomy
  • Minimally invasive neurosurgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Pediatrics, Perinatology, and Child Health

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