“Revolutionizing Neurosurgery: PGIMER Pioneering Minimally Invasive Technique for Giant Pineal Tumors Using Exoscope and Endoscope”
PGIMER Neurosurgeons Prof. Dhandapani SS & Dr Chandrasekhar have published their technique of Minimally Invasive Surgery for a Giant Pineal Tumor using Exoscope & Endoscope in “World Neurosurgery”, the first such in world literature.
Pineal gland responsible for day-night rhythm is located in the middle of the brain, and is difficult to reach. So doing surgery on pineal region tumors is difficult. When the tumor is of large size, it becomes much more of a challenge, as it becomes stuck to critical deep veins of the brain. Such giant tumors often need extensive opening of the skull, and retraction of the brain to reach the tumor, which can result in higher risk of complications. Even then, the tumor margin is often concealed from conventional microscopic view. Hence, separating the tumor margin from all the critical veins is often troublesome.
The team led by Dr. Dhandapani SS, have utilized a novel combination of 3D exoscope, angled endoscope and navigation through a keyhole craniotomy to remove a giant tumor of the pineal gland in a 16 year old patient with excellent outcome. The 3D exoscope offers greater depth of focus and field of view compared to traditional microscopic surgery, and was used in the initial part of surgery. Once some space became available, an angled endoscope was used to separate the tumor from all critical structures, as the endoscope provides a better panoramic view of corners and crevices. They have also previously published on the use of angled endoscopes for pineal region in 2020 (Neurology India), and another novel endoscopic technique to get safe biopsy of pineal tumors in 2022 (Child’s Nervous System).
This minimally invasive technique of Prof. Dhandapani SS is the first in the world for a giant pineal tumor. This method has been used in more than 20 cases with good outcomes. There is no added cost to the patients, as only the existing gadgets of the institute were used.”
“https://authors.elsevier.com/a/1jWjZ6hDEkOYsa
