Tag Archives: resection

Neurosurgery, Print Release

PUBLISHED: Microsurgical Resection of an Intracranial Dural Arteriovenous Fistula

Microsurgical Resection of an Intracranial Dural Arteriovenous Fistula
Marcus Czabanka, MD
Charite Hospital Berlin

This video outlines the surgical steps involved in the microsurgical resection of an intracranial dural arteriovenous fistula (dAVF) in a 74-year-old male patient, highlighting the importance of meticulous planning, intraoperative imaging, and precise dissection techniques. The patient has previously undergone embolization, but recurrence occurred despite the initial treatment, and patient symptoms liked headaches and weakness restarted. A decision was made to perform microsurgical resection of dAVF. The video provides a comprehensive illustration of this procedure, emphasizing the value of microsurgery as a definitive treatment modality for these challenging clinical scenarios.

Neurosurgery, Print Release

PUBLISHED: Intraventricular Tumor Resection

Intraventricular Tumor Resection
Tyler N. Adams1; Marcus Czabanka, MD2
1Louisiana State University School of Medicine
2Charite Hospital Berlin

This is a case of a 49-year-old patient who presented with persistent headaches with no focal neurologic deficit. An MRI was performed which revealed an intraventricular tumor. The lesion was seen entering the third ventricle and potentially compressing both foramina of Monro. This was further confirmed through coronal reconstruction. The proposed method for tumor removal is an interhemispheric, transcallosal approach.

Central nervous system (CNS) tumors, such as this, are uncommon neoplasms that often present with symptoms like headache, nausea, vomiting, ataxia, vertigo, and papilledema. There is also the possibility of hydrocephalus, as the tumor can obstruct cerebrospinal fluid (CSF) outflow, and the development of seizures. These tumors often grow slowly and can be managed with surgical resection, chemotherapy, and/or stereotactic radiosurgery. For intraventricular tumor resection, the surgical approach can vary based on the tumor location, experience, and preference of the surgeon.

Neurosurgery, Print Release

PUBLISHED: Resection of a Sphenoid Wing Meningioma

Resection of a Sphenoid Wing Meningioma
Stefanie Miller1; Marcus Czabanka, MD1
1University of Central Florida College of Medicine
2Charite Hospital Berlin

Sphenoid wing meningiomas are typically benign, slow-growing tumors that may be identified incidentally on imaging or due to a symptomatic presentation from compression of a nearby structure. Located along the sphenoid wing, these tumors may infiltrate or compress the optic nerve, oculomotor nerve, cavernous sinus, or internal carotid artery, causing neurologic deficits such as visual disturbances, headache, paresis, and diplopia.

Surgical resection is considered the first-line treatment for a symptomatic meningioma, but is often challenging due to tumor proximity to these critical neurovascular structures. The most important prognostic factor for recurrence is the completeness of the surgical removal of the tumor, but this goal must be adapted to preserve neurologic function based on individual tumor location and invasion. Here we present a case of a 43-year-old patient diagnosed with a sphenoid wing meningioma after presenting with episodic difficulty speaking and aura-like symptoms who underwent total neurosurgical resection of the tumor via craniotomy.

General Surgery, Print Release

PUBLISHED: Bilateral Posterior Retroperitoneoscopic Adrenalectomy with Cortical Sparing on Right Side

Bilateral Posterior Retroperitoneoscopic Adrenalectomy with Cortical Sparing on Right Side
Yale School of Medicine

Taylor C Brown, MD, MHS
Yale School of Medicine

Tobias Carling, MD, PhD, FACS
Yale School of Medicine

Cortical-sparing adrenalectomy allows for the resection of adrenal tumors while preserving unaffected adrenal tissue to prevent adrenal insufficiency. This is especially important in patients with bilateral adrenal tumors, typically pheochromocytomas.

Posterior retroperitoneoscopic adrenalectomy (PRA) allows for a minimally invasive approach to adrenal gland resection compared with the more traditional laparoscopic transabdominal adrenalectomy and open approaches. This approach is ideal to address patients with bilateral disease and was used in this case of a 31-year-old female patient presenting with bilateral pheochromocytomas in the setting of multiple endocrine neoplasia 2A syndrome and coexisting medullary thyroid carcinoma of the right thyroid lobe. A close review of her imaging demonstrated normal-appearing adrenal cortex tissue on the right side that allowed for cortical-sparing adrenalectomy on that side.

Announcement, General Surgery, Preprint Release, Vascular Surgery

PREPRINT RELEASE: Leiomyosarcoma of the Inferior Vena Cava: Resection and Reconstruction

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Leiomyosarcoma of the Inferior Vena Cava: Resection and Reconstruction
Massachusetts General Hospital
Madhukar S. Patel, MD, MBA, ScM
Department of Surgery, MGH
Jahan Mohebali, MD, MPH
Department of Surgery, Division of Vascular and Endovascular Surgery, MGH
Parsia A. Vagefi, MD, FACS
Department of Surgery, Division of Transplant Surgery, MGH
Alex B. Haynes, MD, MPH, FACS
Department of Surgery, Division of Surgical Oncology, MGH

A woman presented with back pain, and when biopsied, she was found to have an inferior vena cava leiomyosarcoma - specifically involving the infrahepatic vena cava, the origin of the left renal vein, and the hilum of the right kidney. After undergoing preoperative proton beam radiation, the patient has her tumor resected en bloc by Dr. Vagefi and Dr. Haynes. They will also reconstruct the vena cava with a ringed synthetic graft covered by an omental pedicle flap.
Neurosurgery, Preprint Release

PREPRINT RELEASE: Intraventricular Tumor Resection

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Intraventricular Tumor Resection
Charite Hospital Berlin
PD Dr. med. Marcus Czabanka

Neurosurgeon Marcus Czabanka treats an intraventricular tumor found in a patient with persistent headaches by resecting the tumor via an interhemispheric transcallosal approach.
Neurosurgery, Preprint Release

PREPRINT RELEASE: Microsurgical Resection of an Intracranial Dural Arteriovenous Fistula

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Microsurgical Resection of an Intracranial Dural Arteriovenous Fistula
Charite Hospital Berlin
PD Dr. med. Marcus Czabanka

A patient suffering from an AV fistula fed by the external carotid artery, who has failed occlusion via embolization, is being operated on by Dr. Czabanka to definitively treat the fistula. With the help of CT navigation and ICG angiography, Dr. Czabanka is able to microscopically devascularize the problematic malformation.
Neurosurgery, Preprint Release

PREPRINT RELEASE: Resection of a Sphenoid Wing Meningioma

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Resection of a Sphenoid Wing Meningioma
Charite Hospital Berlin
Marcus Czabanka PD Dr. Med.

Watch as Dr. Czabanka navigates delicate territory to expose and excise a meningioma from the sphenoid wing of a symptomatic patient. Use of the microscope becomes crucial to prevent damage to healthy tissue while devascularizing the tumor.