Transparent Tubular Retractor in Cranial Surgery: A Retrospective Analysis

Abstract

Introduction The fourth Industrial Revolution has touched nearly all aspects of neurosurgery and the newer tubular retractor systems are a testimony to this fact. They aid in providing better visualization with minimal damage to those neural structures, which happen to be innocent bystanders overlying the path of deep-seated lesions. In addition to providing better patient outcomes they are surgeon friendly with their ergonomic design and improved stability, thereby causing minimal fatigue, and aid in procedures requiring precision and perseverance. A retrospective study conducted at a single institute analyzed the efficacy of transparent tubular retractors during cranial surgery for deep-seated lesions. Materials and Methods This retrospective study was conducted between April 2015 and July 2018 in a single institute wherein 22 patents with various deep-seated intracranial lesions were operated using the transparent tubular retractor, View Site Brain Access System (VBAS, Vycor Medical Inc.). Observation Of the 22 cases, 45% were of spontaneous intracerebral hemorrhage; 27% were high-grade gliomas; and the rest were colloid cyst, cystic tumors, and metastatic tumors in equal proportion. Total tumor excision was achieved in 27%, while 90% excision was achieved in 45% cases. The overall complication rate was 13%. Conclusion The transparent tubular retractors contribute to minimal invasiveness by causing uniform distribution of retraction pressure and minimal disruption of fiber tracts. Their use has a definite role in improving surgical outcomes for deep-seated intracranial lesions.