Combined Endoscopic and Microsurgical Interhemispheric Transcallosal Approach: A Minimally Invasive Strategy to Manage Complex Third Ventricular Lesions

Abstract

Introduction: Surgical approaches to deep-seated brain pathologies, specifically lesions of the third ventricle, have always been a challenge for neurosurgeons. The endoscopic resection of intraventricular lesions has gained increasing popularity in recent years. However large, vascular, or extremely firm lesions are better approached microsurgically. In these cases, the transcallosal approach remains the most suitable option, to not violate the brain parenchyma, even if it carries a risk of postoperative cognitive and memory deficits in the event of bilateral fornical injury. In this background, the combined use of the endoscopic and microsurgical technique that requires a minimal callosotomy to reach the ventricular compartment, could combine the advantages of both techniques, then increasing the likelihood of a safe and complete resection.