{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T10:12:33Z","timestamp":1780395153744,"version":"3.54.1"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>Tubular brain retractors may improve access to deep-seated brain lesions while potentially reducing the risks of collateral neurological injury associated with standard microsurgical approaches. Here, microscope-assisted resection of lesions using tubular retractors is assessed to determine if it is superior to endoscope-assisted surgery due to the technological advancements associated with modern tubular ports and surgical microscopes.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Following institutional approval of the tubular port, data obtained from the initial 20 patients to undergo transportal resection of deep-seated brain lesions were analyzed in this study. The pathological entities of the resected tissues included metastatic tumors (8 patients), glioma (7), meningioma (1), neurocytoma (1), radiation necrosis (1), primitive neuroectodermal tumor (1), and hemangioblastoma (1). Surgery incorporated endoscopic (5 patients) or microscopic (15) assistance. The locations included the basal ganglia (11 patients), cerebellum (4), frontal lobe (2), temporal lobe (2), and parietal lobe (1). Cases were reviewed for neurological outcomes, extent of resection (EOR), and complications. Technical data for the port, surgical microscope, and endoscope were analyzed.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>EOR was considered total in 14 (70%), near total (&gt; 95%) in 4 (20%), and subtotal (&lt; 90%) in 2 (10%) of 20 patients. Incomplete resection was associated with the basal ganglia location (p &lt; 0.05) and use of the endoscope (p &lt; 0.002). Four of 5 (80%) endoscope-assisted cases were near-total (2) or subtotal (2) resection. Histopathological diagnosis, presenting neurological symptoms, and demographics were not associated with EOR. Complication rates were low and similar between groups.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Initial experience with tubular retractors favors use of the microscope rather than the endoscope due to a wider and 3D field of view. Improved microscope optics and tubular retractor design allows for binocular vision with improved lighting for the resection of deep-seated brain lesions.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.1.jns141113","type":"journal-article","created":{"date-parts":[[2015,8,28]],"date-time":"2015-08-28T15:50:23Z","timestamp":1440777023000},"page":"799-810","source":"Crossref","is-referenced-by-count":57,"title":["Comparison of endoscope- versus microscope-assisted resection of deep-seated intracranial lesions using a minimally invasive port retractor system"],"prefix":"10.3171","volume":"124","author":[{"given":"Christopher S.","family":"Hong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Prevedello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Bradley","family":"Elder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns141113","series-title":"Surg Forum","first-page":"499","article-title":"Brain retraction pressure during intracranial procedures","volume":"26","author":"Albin","year":"1975"},{"key":"b2-jns141113","series-title":"Neurosurgery","first-page":"1052","article-title":"A review of brain retraction and recommendations for minimizing intraoperative brain injury","volume":"33","author":"Andrews","year":"1993"},{"issue":"1 Suppl Operative","key":"b3-jns141113","series-title":"Neurosurgery","first-page":"ons74","article-title":"Evaluation of the 3-dimensional endoscope in transsphenoidal surgery","volume":"73","author":"Barkhoudarian","year":"2013"},{"key":"b4-jns141113","series-title":"Stroke","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1161\/01.STR.8.4.487","article-title":"Evoked potential changes during brain retraction in dogs","volume":"8","author":"Bennett","year":"1977"},{"key":"b5-jns141113","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1097\/00006123-199602000-00013","article-title":"Stereotactic microsurgical craniotomy for the treatment of third ventricular colloid cysts","volume":"38","author":"Cabbell","year":"1996"},{"key":"b6-jns141113","series-title":"Head Neck","doi-asserted-by":"publisher","first-page":"E351","DOI":"10.1002\/hed.23238","article-title":"Combined transoral robotic surgery and endoscopic endonasal approach for the resection of extensive malignancies of the skull base","volume":"35","author":"Carrau","year":"2013"},{"issue":"Suppl 9","key":"b7-jns141113","series-title":"J Med Assoc Thai","first-page":"S82","article-title":"Minimally invasive lumbar disectomy with the tubular retractor system: 4\u20137 years follow-up","volume":"95","author":"Chotigavanichaya","year":"2012"},{"issue":"3 Suppl Operative","key":"b8-jns141113","series-title":"Neurosurgery","first-page":"ons198","article-title":"Stereotactically guided endoscopic port surgery for intraventricular tumor and colloid cyst resection","volume":"67","author":"Engh","year":"2010"},{"key":"b9-jns141113","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1227\/00006123-199506000-00040","article-title":"Mannitol, intracranial pressure and vasogenic edema","volume":"36","author":"Feldman","year":"1995"},{"key":"b10-jns141113","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1007\/s00586-009-0964-2","article-title":"Comparison of a minimally invasive procedure versus standard microscopic discotomy: a prospective randomised controlled clinical trial","volume":"18","author":"Franke","year":"2009"},{"key":"b11-jns141113","series-title":"Surg Technol Int","first-page":"47","article-title":"Use of transparent plastic tubular retractor in surgery for deep brain lesions: a case series","volume":"19","author":"Herrera","year":"2010"},{"key":"b12-jns141113","series-title":"Otolaryngology","doi-asserted-by":"publisher","first-page":"ORL-934","DOI":"10.1177\/019459987808600618","article-title":"The Leyla retractor: use in acoustic neuroma and neurotologic surgery","volume":"86","author":"Horwitz","year":"1978"},{"key":"b13-jns141113","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1038\/jcbfm.1990.11","article-title":"Continuous nimodipine treatment attenuates cortical infarction in rats subjected to 24 hours of focal cerebral ischemia","volume":"10","author":"Jacewicz","year":"1990"},{"key":"b14-jns141113","series-title":"Laryngoscope","doi-asserted-by":"publisher","first-page":"2112","DOI":"10.1002\/lary.24037","article-title":"Olfactory functions after transsphenoidal pituitary surgery: endoscopic versus microscopic approach","volume":"123","author":"Kahilogullari","year":"2013"},{"key":"b15-jns141113","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.3171\/2010.10.JNS09406","article-title":"Endoscopic endonasal skull base surgery: analysis of complications in the authors\u2019 initial 800 patients","volume":"114","author":"Kassam","year":"2011"},{"key":"b16-jns141113","series-title":"J Neurosurg Sci","first-page":"149","article-title":"Future perspectives in stereotactic neurosurgery: stereotactic microsurgical removal of deep brain tumors","volume":"33","author":"Kelly","year":"1989"},{"key":"b17-jns141113","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"301","DOI":"10.3171\/jns.1988.69.2.0301","article-title":"The stereotaxic retractor in computer-assisted stereotaxic microsurgery. Technical note","volume":"69","author":"Kelly","year":"1988"},{"key":"b18-jns141113","series-title":"Appl Neurophysiol","first-page":"107","article-title":"Computer-interactive stereotactic resection of deep-seated and centrally located intra-axial brain lesions","volume":"50","author":"Kelly","year":"1987"},{"key":"b19-jns141113","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1097\/BSD.0b013e3182706ce7","article-title":"Minimally invasive lateral lumbar interbody fusion: clinical and radiographic outcome at a minimum 2-year follow-up","volume":"28","author":"Kotwal","year":"2015"},{"key":"b20-jns141113","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"626","DOI":"10.3171\/jns.1987.66.4.0626","article-title":"A new fixation device for the Leksell stereotaxic system. Technical note","volume":"66","author":"Leksell","year":"1987"},{"key":"b21-jns141113","series-title":"J Cereb Blood Flow Metab","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1038\/jcbfm.1991.138","article-title":"Effects of dextromethorphan on regional cerebral blood flow in focal cerebral ischemia","volume":"11","author":"Lo","year":"1991"},{"key":"b22-jns141113","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"613","DOI":"10.3171\/2012.11.JNS112020","article-title":"Value of endoscopy for maximizing tumor removal in endonasal transsphenoidal pituitary adenoma surgery","volume":"118","author":"McLaughlin","year":"2013"},{"issue":"2 Suppl","key":"b23-jns141113","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"S18.e1","DOI":"10.1016\/j.wneu.2012.02.022","article-title":"Endoneurosurgical resection of intraventricular and intraparenchymal lesions using the port technique","volume":"79","author":"McLaughlin","year":"2013"},{"key":"b24-jns141113","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"109","DOI":"10.3171\/jns.1987.66.1.0109","article-title":"Treatment of experimental focal cerebral ischemia with mannitol. Assessment by intracellular brain pH, cortical blood flow, and electroencephalography","volume":"66","author":"Meyer","year":"1987"},{"key":"b25-jns141113","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1227\/01.neu.0000279725.13521.a3","article-title":"Stereotactic volumetric resection of thalamic pilocytic astrocytomas","volume":"61","author":"Moshel","year":"2007"},{"key":"b26-jns141113","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1444","DOI":"10.1227\/NEU.0b013e31820b4f6a","article-title":"Endoscopic port surgery for resection of lesions of the cerebellar peduncles: technical note","volume":"68","author":"Ochalski","year":"2011"},{"key":"b27-jns141113","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1227\/00006123-199008000-00029","article-title":"Stereotactic guiding tube for open-system endoscopy: a new approach for the stereotactic endoscopic resection of intra-axial brain tumors","volume":"27","author":"Otsuki","year":"1990"},{"key":"b28-jns141113","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1007\/BF01418523","article-title":"Free-standing, stereotactic, microsurgical retraction technique in \u201ckey hole\u201d intracranial procedures","volume":"108","author":"Patil","year":"1991"},{"key":"b29-jns141113","series-title":"Adv Orthop","first-page":"645321","article-title":"Minimal invasive decompression for lumbar spinal stenosis","volume":"2012","author":"Popov","year":"2012"},{"key":"b30-jns141113","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"1629","DOI":"10.1007\/s00701-013-1766-1","article-title":"Extracapsular dissection technique with the cotton swab for pituitary adenomas through an endoscopic endonasal approach \u2014 how I do it","volume":"155","author":"Prevedello","year":"2013"},{"key":"b31-jns141113","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1055\/s-0031-1273734","article-title":"Minimally invasive trans-portal resection of deep intracranial lesions","volume":"54","author":"Raza","year":"2011"},{"key":"b32-jns141113","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"516","DOI":"10.3171\/2011.2.PEDS10515","article-title":"Use of a minimally invasive tubular retraction system for deep-seated tumors in pediatric patients","volume":"7","author":"Recinos","year":"2011"},{"key":"b33-jns141113","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.wneu.2013.07.013","article-title":"Comparison of microscopic and endoscopic approaches to the cerebellopontine angle","volume":"82","author":"Takemura","year":"2014"},{"key":"b34-jns141113","series-title":"J Neurol Surg A Cent Eur Neurosurg","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1055\/s-0032-1330119","article-title":"Minimally invasive access to the posterior cranial fossa: an anatomical study comparing a retrosigmoidal endoscopic approach to a microscopic approach","volume":"74","author":"Van Rompaey","year":"2013"},{"key":"b35-jns141113","series-title":"Neurol India","doi-asserted-by":"publisher","first-page":"74","DOI":"10.4103\/0028-3886.76870","article-title":"A new minimally invasive tubular brain retractor system for surgery of deep intracerebral hematoma","volume":"59","author":"Yadav","year":"2011"},{"key":"b36-jns141113","series-title":"Acta Neurochir Suppl (Wien)","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1007\/978-3-7091-9029-6_27","article-title":"Transposition of image-defined trajectories into arc-quadrant centered stereotactic systems","volume":"46","author":"Zamorano","year":"1989"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/124\/3\/article-p799.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/124\/3\/article-p799.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/124\/3\/article-p799.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,9]],"date-time":"2024-03-09T09:58:01Z","timestamp":1709978281000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/124\/3\/article-p799.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3]]},"references-count":36,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2015.1.jns141113","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3]]}}}