Exoscope-based supracerebellar infratentorial approach for a pineal meningioma in the prone position

Arka N Mallela; Tritan J Plute; Hussam Abou-Al-Shaar; David T Fernandes Cabral; Constantinos G Hadjipanayis

doi:10.3171/2023.10.FOCVID23155

Exoscope-based supracerebellar infratentorial approach for a pineal meningioma in the prone position

Neurosurg Focus Video. 2024 Jan 1;10(1):V15. doi: 10.3171/2023.10.FOCVID23155. eCollection 2024 Jan.

Authors

Arka N Mallela¹, Tritan J Plute¹, Hussam Abou-Al-Shaar¹, David T Fernandes Cabral¹, Constantinos G Hadjipanayis^{1

2}

Affiliations

¹ Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and.
² Hillman Cancer Center, Pittsburgh, Pennsylvania.

Abstract

The supracerebellar infratentorial (SCIT) approach is a well-described corridor to lesions in the quadrigeminal cistern, pineal gland, and dorsal midbrain. It can be performed in the prone or sitting position. The sitting position offers the benefit of gravity retraction of the cerebellum but comes at the expense of nonergonomic hand positioning and the potential risk of air embolism. The 3D exoscope is an alternative to the operating microscope and permits the SCIT approach in the prone position with excellent visualization. This video demonstrates exoscope-based SCIT approach for resection of a pineal meningioma in the prone position. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23155.

Keywords: exoscope; intraoperative visualization; pineal gland; prone; quadrigeminal cistern; supracerebellar infratentorial.