Full-Endoscopic Surgery for Hypothalamic Hamartoma Resection


Gulsever C. I., Öztürk M., Sahin D., Koksoy F., Ornek V., Aydoseli A., ...More

Journal of Visualized Experiments, vol.2024, no.206, 2024 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 2024 Issue: 206
  • Publication Date: 2024
  • Doi Number: 10.3791/64705
  • Journal Name: Journal of Visualized Experiments
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, INSPEC, MEDLINE
  • Istanbul University Affiliated: Yes

Abstract

Hypothalamic hamartomas (HH) are rare developmental anomalies of the inferior hypothalamus that often cause refractory epilepsy, including gelastic seizures. Surgical resection is an effective method to treat drug-resistant epilepsy and endocrinopathy in a suitable patient group. Open surgery, endoscopic surgery, ablative procedures, and stereotactic radiosurgery can be utilized. In this study, we aimed to describe the full-endoscopic approach for HH resection. The technique involves the use of an intraoperative ultrasonography (USG) system, a 30° rigid endoscope system that has an outside diameter of 2.7 mm with two working channels, a stylet that has an outer diameter of 3.8 mm, a monopolar coagulation electrode, a fiberoptic light guide, and the endovision system. Microforceps and monopolar electrocautery are the two main surgical instruments for HH removal. The protocol is easy to apply after a particular learning curve has been passed and shorter than open surgical approaches. It leads to less blood loss. Full-endoscopic surgery for HH is a minimally invasive technique that can be applied safely and effectively with good seizure and endocrinological outcomes. It provides low surgical site pain and early mobilization.