Microroll Retractor for Surgical Resection of Brainstem Cavernomas

Abstract

Safe and complete surgical resection of brainstem cavernoma is difficult without injury surrounding normal structures because the lesions are deep and intra-axial. In this article, the authors describe the "microroll retractor" technique for brainstem cavernoma surgery. The microroll retractor is made of expanded polytetrafluoroethylene sheet. The sheet is cut in several sizes of square piece and transformed into a tubular shape. We insert this roll retractor via minimal brain incision and keep surgical corridor without usual spatulas during lesionectomy. This technique was adopted for 7 patients with brainstem cavernomas. In all patients, we achieved total excision; improvement was recorded in 6 patients, and no change was recorded in 1 patient. The microroll retractor is extremely simple but provides enough surgical corridors for safe total resection of brainstem cavernomas.