Minitubular Transcortical Microsurgical Approach for Gross Total Resection of Third Ventricular Colloid Cysts: Technique and Assessment

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"Open" transcortical and transcallosal approaches allow gross total colloid cyst resection but require a wider surgical corridor through normal brain tissue compared with endoscopic techniques. Although the use of tubular retractor systems has been previously reported, the minimum required diameter size for the retractor tube has been approximately 16 to 22 mm. Our objective was to explore the use of smaller retractor tubes for total resection of colloid cysts. A minitubular retractor with a 12-mm diameter was used to access and resect colloid cysts using microsurgical techniques while preserving stereoscopic vision as an alternative to open and endoscopic surgical routes. This technique was adopted in five patients with larger than 10-mm colloid cysts to allow for gross total resection of the cysts in every case without any complication. Smaller retractor tubes may be used for resection of colloid cysts while minimizing brain retraction injury and potentially improving outcomes.