Novel Use of the Aurora Surgiscope System for Minimally Invasive Resection of Intraparenchymal Lesions: A Case Series. Issue 3 (14th September 2022)

• Record Type: Journal Article
• Authors: Achey, Rebecca L.; Soni, Pranay; Kashkoush, Ahmed; Davison, Mark; Kondylis, Efstathios; Moore, Nina; Bain, Mark
• Is Part Of: Operative neurosurgery. Volume 23:Issue 3(2022)
• Page Start: 182
• Page End: 187
• Publication Date: 2022-09-14
• Subjects: Cavernous malformation -- Intracranial hemorrhage -- Minimally invasive neurosurgery -- Neurosurgical surgiscope -- Pilocytic astrocytoma; Nervous system -- Surgery -- Periodicals; 617.480590
• DOI: 10.1227/ons.0000000000000292
• Languages: English
• ISSNs: 2332-4252

Abstract

Abstract : BACKGROUND: Minimally invasive surgery (MIS) for intracranial pathology minimizes surgical morbidity but can come at the cost of operator ergonomics and technical surgical success. Here, the authors present a case series to report the first use of a novel 15-mm tubular retraction system with integrated lighting and visualization capabilities for MIS access to intracranial lesions. OBJECTIVE: To demonstrate feasibility and effectiveness of the 15-mm Aurora Surgiscope (Integra Lifesciences) for intracranial MIS approaches. METHODS: The 15-mm Aurora Surgiscope facilitated MIS approach to gain access to intraparenchymal pathologies. The device consists of a tubular access system with integrated light source and a reusable control unit that modifies video parameters. The port was inserted along a preplanned trajectory through a mini-craniotomy. Bimanual access allowed the surgeon to comfortably dissect/resect lesional tissue using high-quality video. RESULTS: Four patients are presented. In cases 1 and 2, the authors evacuated acute intracerebral hemorrhages. Both had <15 cc hemorrhage with improved or stable neurological examination. In case 3, the authors performed gross total resection of a cerebellar pilocytic astrocytoma. In case 4, the authors resected a mesial posterior temporal cavernoma. No perioperative/technical complications were noted. CONCLUSION: The Aurora Surgiscope system is a novel integrated tubular retraction, lighting, and visualization system that allows access to a wide variety of pathologies using a MIS approach. The Surgiscope allows the surgeon to use bimanual dexterity through a small access port while limiting the need for additional equipment such as microscope, exoscope, or endoscope.