Publication year: 2012
Source:World Neurosurgery
Aaron Mohanty, Bobbye Jo Thompson, Joel Patterson
Objective Conventionally, neuroendoscopic excision of intraventricular tumors has been difficult and time consuming due to lack of an effective decompression system that can be used through the working channel of the endoscope. Methods The authors report their initial experience in pure endoscopic excision of large intraventricular tumors with the minimally invasive NICO Myriad system. The NICO Myriad is a side cutting soft tissue aspiration system which employs an inner reciprocating canula and an outer stationary sheath with a side port. During decompression, applied suction approximates the tumor into the lumen of the outer sheath with the inner canula excising the tissue by oscillation of the cutting edge. The tumor is then removed by aspiration through the inner sheath. Results Three patients with large intraventricular tumors were operated by a pure endoscopic approach using a Gaab's rigid endoscope and the NICO Myriad system. Of these, 2 had intraventricular craniopharyngiomas and one had a lateral ventricular subependymoma. The tumor size varied between 1.9 and 4.5 cm in the largest diameter. A relatively firm and solid tumor was encountered in 2 and a multicystic tumor with thick adherent walls in one. The tumor could be subtotally removed in one and near totally in two. There were no long term complications. Conclusion The NICO Myriad is a highly effective tumor decompression system which can be effectively used in pure endoscopic approach to intraventricular lesions.
Júlio Leonardo B. Pereira
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