神经内镜辅助锁孔手术治疗颅内深部病变

Neuroendoscope-assisted Surgery through Keyhole Approach for Treatment of Intracranial Deep Lesions

目的探讨神经内镜辅助锁孔手术治疗颅内深部病变相关手术入路及显微手术技术。方法根据高分辨诊断影像结果,制定个体化手术方案。手术经由头皮小切口,作直径约2cm的骨窗开颅,在充分释放脑脊液令脑组织自动回缩后,从脑外间隙抵达深部病变;通过有序地解剖相关神经、血管间隙的蛛网膜下腔,作无创伤通道,完成对病变的显露。采用神经内镜辅助的显微手术技术治疗了颅内深部病变51例。结果本组51例颅内深部病变,经神经内镜辅助的显微手术技术治愈,无手术并发症发生。结论神经内镜辅助的锁孔入路较常规显微手术入路更为微创、精细、准确、安全,是一种有临床实用价值的神经外科微创显微手术新技术。

Objective To explore the operative approach and neuroendoscope-assisted microsurgical technique for the treatment of intracranial deep lesions. Methods According to high resolution diagnostic imagings, the individual operation plan was worked out. The bone window 2 cm in diameter was made through a small scalp incision. The deep lesion was reached through the gap between the skull and brain after the CSF was released and the cerebral tissue shrank. The lesions were noninvasively exposed and treated by the endoscope- assisted microsurgical technique in 51 patients with intracranial deep lesions. Results All the 51 patients with intracranial deep lesions were cured by endoscope-assisted microsurgery technigue. No postoperative complications occurred. Conclusions The neuroendoscope-assisted microsurgery through the keyhole approach is more minimally invasive, more accurate, finer and safer than the routine microsurgery and is a new valuable and minimally invasive micronerosurgical technique.