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  1. Article ; Online: Endoscopic Evacuation of Putaminal Hemorrhage Using the Trans-Middle Temporal Gyrus Approach: Technical Notes and Case Presentations.

    Yamazaki, Ken / Ogiwara, Toshihiro / Kitamura, Satoshi / Fujii, Yu / Yamazaki, Daisuke / Kuwabara, Haruki / Funato, Kohei / Hanaoka, Yoshiki / Horiuchi, Tetsuyoshi

    Journal of neurological surgery. Part A, Central European neurosurgery

    2024  

    Abstract: Background:  The development of minimally invasive endoscopic neurosurgery has enabled widespread application of endoscopic surgery via the ipsilateral transfrontal approach for putaminal hematoma evacuation. However, this approach is unsuitable for ... ...

    Abstract Background:  The development of minimally invasive endoscopic neurosurgery has enabled widespread application of endoscopic surgery via the ipsilateral transfrontal approach for putaminal hematoma evacuation. However, this approach is unsuitable for putaminal hematomas that extend into the temporal lobe. We adopted the endoscopic trans-middle temporal gyrus approach, instead of the conventional surgical approach, for the management of these complicated cases and determined its safety and feasibility.
    Methods:  Twenty patients with putaminal hemorrhage underwent surgical treatment at the Shinshu University Hospital between January 2016 and May 2021. Of these, two patients with left putaminal hemorrhage that extended into the temporal lobe underwent surgical treatment using the endoscopic trans-middle temporal gyrus approach. The procedure entailed the use of a thinner transparent sheath to reduce the technique's invasiveness, a navigation system to determine the location of the middle temporal gyrus and the sheath's trajectory, and an endoscope with a 4K camera for higher image quality and utility. The sylvian fissure was compressed superiorly using our novel "port retraction technique" (i.e., by tilting the transparent sheath superiorly) to avoid damage to the middle cerebral artery and Wernicke's area.
    Results:  The endoscopic trans-middle temporal gyrus approach allowed sufficient hematoma evacuation and hemostasis under endoscopic observation without any surgical complexities or complications. The postoperative course was uneventful in both patients.
    Conclusion:  The endoscopic trans-middle temporal gyrus approach for putaminal hematoma evacuation helps avoid damage to normal brain tissue, which could result from the wide range of motion of the conventional technique, particularly when the hemorrhage extends to the temporal lobe.
    Language English
    Publishing date 2024-04-15
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2651663-9
    ISSN 2193-6323 ; 2193-6315
    ISSN (online) 2193-6323
    ISSN 2193-6315
    DOI 10.1055/a-2053-2999
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Endoscopic Evacuation of Putaminal Hemorrhage Using the Trans-Middle Temporal Gyrus Approach: Technical Notes and Case Presentations

    Yamazaki, Ken / Ogiwara, Toshihiro / Kitamura, Satoshi / Fujii, Yu / Yamazaki, Daisuke / Kuwabara, Haruki / Funato, Kohei / Hanaoka, Yoshiki / Horiuchi, Tetsuyoshi

    Journal of Neurological Surgery Part A: Central European Neurosurgery

    2023  

    Abstract: Background: The development of minimally invasive endoscopic neurosurgery has enabled widespread application of endoscopic surgery via the ipsilateral transfrontal approach for putaminal hematoma evacuation. However, this approach is unsuitable for ... ...

    Abstract Background: The development of minimally invasive endoscopic neurosurgery has enabled widespread application of endoscopic surgery via the ipsilateral transfrontal approach for putaminal hematoma evacuation. However, this approach is unsuitable for putaminal hematomas that extend into the temporal lobe. We adopted the endoscopic trans-middle temporal gyrus approach, instead of the conventional surgical approach, for the management of these complicated cases and determined its safety and feasibility.
    Methods: Twenty patients with putaminal hemorrhage underwent surgical treatment at the Shinshu University Hospital between January 2016 and May 2021. Of these, two patients with left putaminal hemorrhage that extended into the temporal lobe underwent surgical treatment using the endoscopic trans-middle temporal gyrus approach. The procedure entailed the use of a thinner transparent sheath to reduce the technique's invasiveness, a navigation system to determine the location of the middle temporal gyrus and the sheath's trajectory, and an endoscope with a 4K camera for higher image quality and utility. The sylvian fissure was compressed superiorly using our novel “port retraction technique” (i.e., by tilting the transparent sheath superiorly) to avoid damage to the middle cerebral artery and Wernicke's area.
    Results: The endoscopic trans-middle temporal gyrus approach allowed sufficient hematoma evacuation and hemostasis under endoscopic observation without any surgical complexities or complications. The postoperative course was uneventful in both patients.
    Conclusion: The endoscopic trans-middle temporal gyrus approach for putaminal hematoma evacuation helps avoid damage to normal brain tissue, which could result from the wide range of motion of the conventional technique, particularly when the hemorrhage extends to the temporal lobe.
    Keywords endoscopy ; endoscopic evacuation ; putaminal hemorrhage ; surgical strategy
    Language English
    Publishing date 2023-03-13
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 2651663-9
    ISSN 2193-6323 ; 2193-6315
    ISSN (online) 2193-6323
    ISSN 2193-6315
    DOI 10.1055/a-2053-2999
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  3. Article ; Online: Assessment of collateral venous flow using temporary clip placement at ICG videoangiography.

    Hardian, Ridzky Firmansyah / Hanaoka, Yoshiki / Funato, Kohei / Agata, Masahiro / Ito, Kiyoshi / Horiuchi, Tetsuyoshi

    Acta neurochirurgica

    2020  Volume 163, Issue 9, Page(s) 2533–2536

    Abstract: Background: As there are many collateral pathways between venous systems, intraoperative venous injury rarely induces venous infarction. In some patients, however, venous injury during microsurgical manipulation may cause acute and/or delayed serious ... ...

    Abstract Background: As there are many collateral pathways between venous systems, intraoperative venous injury rarely induces venous infarction. In some patients, however, venous injury during microsurgical manipulation may cause acute and/or delayed serious complications. Although intraoperative evaluation using indocyanine green (ICG) videoangiography is very useful, it is difficult to assess the flow direction using this technique.
    Method: A simple technique using temporary clips and ICG videoangiography was applied to assess the collateral venous pathway in 4 cases of surgical manipulation-related injury or occlusion of the main superficial Sylvian vein in patients with aneurysm.
    Results: The flow direction and collateral pathway can be easily visualized after release of temporary occlusion.
    Conclusions: A collateral venous pathway can be evaluated with the present simple technique described here.
    MeSH term(s) Cerebral Angiography ; Coloring Agents ; Humans ; Indocyanine Green ; Neurosurgical Procedures ; Surgical Instruments
    Chemical Substances Coloring Agents ; Indocyanine Green (IX6J1063HV)
    Language English
    Publishing date 2020-10-21
    Publishing country Austria
    Document type Journal Article
    ZDB-ID 80010-7
    ISSN 0942-0940 ; 0001-6268
    ISSN (online) 0942-0940
    ISSN 0001-6268
    DOI 10.1007/s00701-020-04617-x
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  4. Article: Frontal Encephalocele Plus Epilepsy: A Case Report and Review of the Literature.

    Yamazaki, Ken / Kanaya, Kohei / Uda, Takehiro / Fukuyama, Tetsuhiro / Nishioka, Makoto / Hoshino, Yumi / Kaneko, Tomoki / Hardian, Ridzky Firmansyah / Yamazaki, Daisuke / Kuwabara, Haruki / Funato, Kohei / Horiuchi, Tetsuyoshi

    Brain sciences

    2023  Volume 13, Issue 1

    Abstract: An encephalocele is a pathological brain herniation caused by osseous dural defects. Encephaloceles are known to be regions of epileptogenic foci. We describe the case of a 44-year-old woman with refractory epilepsy associated with a frontal skull base ... ...

    Abstract An encephalocele is a pathological brain herniation caused by osseous dural defects. Encephaloceles are known to be regions of epileptogenic foci. We describe the case of a 44-year-old woman with refractory epilepsy associated with a frontal skull base encephalocele. Epilepsy surgery for encephalocele resection was performed; however, the epilepsy was refractory. A second epilepsy surgery for frontal lobectomy using intraoperative electroencephalography was required to achieve adequate seizure control. Previous reports have shown that only encephalocele resection can result in good seizure control, and refractory epilepsy due to frontal lobe encephalocele has rarely been reported. To the best of our knowledge, this is the first report of frontal encephalocele plus epilepsy in which good seizure control using only encephalocele resection was difficult to achieve. Herein, we describe the possible mechanisms of encephalocele plus epilepsy and the surgical strategy for refractory epilepsy with encephalocele, including a literature review.
    Language English
    Publishing date 2023-01-09
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2651993-8
    ISSN 2076-3425
    ISSN 2076-3425
    DOI 10.3390/brainsci13010115
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  5. Article ; Online: Intraoperative Image-Guided Surgery for Gliomas in the Smart Cyber Operating Theater (SCOT): A Preliminary Clinical Application.

    Ogiwara, Toshihiro / Fujii, Yu / Hanaoka, Yoshiki / Kitamura, Satoshi / Kuwabara, Haruki / Funato, Kohei / Inomata, Yuki / Yamazaki, Daisuke / Yamazaki, Ken / Murase, Hiromu / Yokota, Akifumi / Hardian, Ridzky Firmansyah / Goto, Tetsuya / Hongo, Kazuhiro / Horiuchi, Tetsuyoshi

    World neurosurgery

    2022  Volume 160, Page(s) e314–e321

    Abstract: Background: Various devices exist for glioma image-guided surgery to improve tumor resection. These devices work as stand-alone units, making the flow of operative information complicated and disjointed. A novel networked operating room, the Smart Cyber ...

    Abstract Background: Various devices exist for glioma image-guided surgery to improve tumor resection. These devices work as stand-alone units, making the flow of operative information complicated and disjointed. A novel networked operating room, the Smart Cyber Operating Theater (SCOT), has been developed, integrating stand-alone medical devices using the OPeLiNK communication interface. We report and evaluate the impact of SCOT for glioma surgery and our initial experiences.
    Methods: Patients with gliomas who underwent tumor resection in SCOT between July 2018 and June 2021 were retrospectively reviewed. Various types of intraoperative information were integrated, managed, and shared with the surgical strategy desk using OPeLiNK. Patients' demographics, tumor characteristics, treatment details, and outcomes were obtained. The impact of the SCOT system was evaluated.
    Results: Twenty-seven patients, with a mean age of 48.6 years (range, 13-88 years), met the inclusion criteria. We successfully completed all the surgical procedures using SCOT. The mean operation time was 420.6 minutes (range, 225-667 minutes).Gross total resection was accomplished in 13 patients (48.1%), subtotal resection in 4 (14.8%), and partial resection in 10 (37.0%). The main surgeon in the operating room and other neurosurgeons at the strategy desk shared and discussed the information in real time during the procedures.
    Conclusions: The use of SCOT was shown to be safe and feasible in glioma surgery. This study suggests that SCOT may improve surgical outcomes and educational impact by sharing information in real time with the strategy desk.
    MeSH term(s) Brain Neoplasms/pathology ; Brain Neoplasms/surgery ; Glioma/pathology ; Glioma/surgery ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurosurgical Procedures/methods ; Operating Rooms ; Retrospective Studies ; Surgery, Computer-Assisted
    Language English
    Publishing date 2022-01-10
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2022.01.012
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