Minimally invasive tubular corticotomy using “Dandy cannula-glove technique” for trans-cortical approaches to the ventricular lesions. Technical note

Abstract Access to deep-seated intraventricular lesions frequently requires a focal corticotomy to allow adequate exposure of the affected area. This is necessary to create a surgical corridor to the lesion. However, this may lead to iatrogenic trauma of healthy cortical tissue, subcortical white matter tracts, cortical and subependymal veins. A sulcal approach minimises length of the trajectory through healthy brain tissue but still involves substantial destruction of grey and white matter structures. The conventional corticotomy involves coagulation or suctioning of considerable volume of tissue until the lesion is reached. To minimise damage to the normal brain tissue during ventricular access, the authors describe a technique using Dandy cannula and a finger of an ordinary surgical rubber glove to access ventricle and to obtain the much-desired radial exposure through a tubular corridor. In addition, the Dandy cannula can be linked to frameless neuronavigation to facilitate accurate and shortest trajectory to the lesion.