2015 Volume 24 Issue 9 Pages 623-631
We studied the usefulness of the exoscope (VITOM Telescope, Karl Storz) assisted surgery combined use with the ViewSite (ViewSiteTM Brain Access System, Vycor Medical) for surgery of deep-seated tumors. Total removal of 6 deep-seated intraparenchymal tumors associated with severe brain edema was performed under visualization by an exoscope following insertion of a clear tube retractor between March and November 2014. Removal of the tumor was started from its surface at the point of contact with the tip of the ViewSite, and was continued in “inside to outside” fashion. Gross total resection was achieved in five patients with metastasis (n=4) or radiation necrosis (n=1), and biopsy was performed in one patient with malignant lymphoma. Microscopic examination found residual tumor in one case, and microscopic hemostasis was required in one case. The exoscope can provide a long working distance and a clear view from outside the operation field, so combined use with the ViewSite is very promising for surgery of deep-seated tumors.