FIELD:
neurosurgery and
neurology.SUBSTANCE: after
surgical access, a vessel located on the surface of the
tumor tissue and extending into adjacent areas of the cortex is visualized. On both sides of the vessel, a bipolar
electrode is used to coagulate the areas of the cortex affected by the tumor. Then, using microscissors, the
arachnoid membrane is opened in the area of coagulation zones. An encephalotomy is performed. Next, subpial resection of the tumor in these areas is performed using an ultrasonic destroyer-
aspirator, preserving the
arachnoid membrane in which the preserved vessel passes. When visualizing a vessel located deep in the groove,
dissection of the groove is performed while preserving the
arachnoid membrane in which the vessel passes. The tumor around the vessel is resected using an ultrasonic destroyer-
aspirator. In this case, first the part of the tumor on one side of the vessel is resected, then the part on the other side. These resection areas are connected to each other under the vessel. Then the residual tumor fragments on the vessel are removed. When visualizing a vessel passing through a tumor to healthy areas of the brain, this vessel is preserved, and the
tumor tissue is separated from it along the periphery using an ultrasonic destroyer-
aspirator. During the isolation of cortical and subcortical vessels, they are irrigated with
saline solution. Then, through the resulting “intervascular windows,” deeply located tumor fragments are removed.EFFECT: method allows for the preservation of
blood flow in cortical vessels during the removal of glial brain tumors, reducing the risk of developing ischemic complications in functionally significant areas of the cortex adjacent to the
tumor resection zone, as well as in the subcortical structures of the brain, which, as a consequence, is associated with lower risks of developing postoperative
neurological deficit.1 cl, 3 ex