Laser Surgery of Basal, Orbital and Ventricular Meningiomas which are Difficult to Extirpate by Conventional Methods

抄録

The authors discuss laser surgery of meningiomas which are difficult or impossible to remove by conventional methods. The CO₂ laser surgical unit (scalpel), Medilaser-S, Model MEL-442, was originally developed for neurosurgery by Takizawa and his team. One of the conspicuous advantages of the CO₂ laser scalpel is its ability to remove highly vascularized tumors with minimum bleeding. Another advantage is that it enables a surgeon to remove a firm tumor precisely without using mechanical force. The cases included in this paper are highly vascularized sphenoid ridge meningioma, giant falx meningioma, firm tuberculum sellae meningioma, tentorial meningioma, ventricular meningioma and orbital meningioma. Disadvantages of the CO₂ laser scalpel and methods to offset them are also discussed. These disadvantages may be surmounted by the combined use of the electrosurgical unit, cryosurgical unit, CUSA system, etc. The CO₂ laser scalpel is not ideal, but it is no doubt a break through in surgery of brain tumors which are difficult to remove by conventional methods.