Efficacy of an Ultrasonic Aspirator for Compartmental Removal of Large Meningiomas

Abstract

Purpose: We demonstrated a technique for dividing large meningiomas using a light, miniaturized ultrasonic aspirator (UA) handpiece simultaneously with bipolar coagulator forceps. Representative Cases: Two large meningiomas were divided into 3 and 4 compartments, respectively, and removed. Compartmental removal using UA made it possible to locate and safely dissect important deep structures. Technique: The tumor was cut along a planned dividing plane to make a disk-like space using the UA handpiece in one hand and the bipolar coagulator forceps in the other. The bottom of the tumor wall was opened widely to safely dissect the tumor-brain boundary under direct vision. The divided compartment was retracted toward the main tumor mass and dissected with minimal injury to the surrounding tissue. Conclusion: Simultaneous use of the UA and bipolar coagulator facilitates the compartmental removal of large meningiomas in less time and with less bleeding.