Abstract
Brain retraction is often required for developing a surgical corridor during the resection of deeply seated intracranial lesions. Traditional blade retractors distribute pressure asymmetrically and may case local tissue damage. Tubular retractors minimize this pitfall by distributing pressure evenly, which has been shown to translate to significant safety and efficacy data. Further qualified reports regarding the use of tubular retractors are of interest.
We performed a retrospective analysis of one surgeon's experience with twenty cases of minimally invasive resection with the VBAS (N=7) and BrainPath (N=13) systems. Additionally, a comprehensive review of all published cases of tubular retractor systems used for resection of subcortical neoplastic, cystic, infectious, vascular, and hemorrhagic lesions was conducted. .
Of the twenty analyzed cases, gross total resection was achieved in eighteen cases with an associated 10% immediate postop complication rate and 5% long term complication rate. A comprehensive review of the literature demonstrated 30 papers describing 536 cases of resection of deep neoplastic or colloid cysts with an overall complication rate of 9.1%.
Tubular retractor systems have a favorable safety profile and are an important tool in the armamentarium of a neurosurgeon for the resection of deep intracranial lesions.
