August 14, 2016
Here's another video discussing the technical nuances for resection of the colloid cyst via the transcallosal approach. This video also reviews some of the pitfalls in using the microscope to remove the colloid cyst. In this case, this colloid cyst has led to relatively moderate hydrocephalus. You can see the location of the cyst, neither foramen is significantly affected in order to be selected for removal of the cyst. Therefore, a right-sided approach was selected with the patient in the lateral position. The dura was opened in a curvilinear fashion. Here's the location of the superior sagittal sinus. The interhemispheric fissure was entered. The single eye were separated, small callosotomy was completed. Here's ependyma. As the septum pellucidum was herniating because of hydrocephalus within the left ventricle, both leaflets of the septum pellucidum were fenestrated so that a septum can be mobilized out of our operative corridor. Here's a more de magnified view. Here's the cyst within the foramen. You can see that my fellow is using the microscope as relatively inappropriate angle to the working angle of the instruments. And therefore, the light is not really illuminating the dissection field effectively. Here's the cyst that's being removed out of the foramen. Now the microscope has been repositioned, so it is not coaxial with axis of their dissecting instruments. And now ample amount of light is available. Here's the foramen, the cyst was completely removed. Here's an external ventricular drain that was placed previous to the operation. Any obstruction within the CSF pathways is relieved. It was a view of contralateral foramen a moment ago. Following hemostasis, closure is performance the standard fashion. Here's their three months postoperative MRI which reveals complete removal of the cyst with a resolution of the hydrocephalus, and this patient made an excellent recovery, thank you.
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