Abstracts

Corpus callosotomy is a highly effective surgical procedure for epilepsy but has become less utilized due to morbidity that is largely attributable to the approach. Advances in neuroendoscopy have allowed significant progress in reducing invasiveness of neurosurgical intervention while maintaining effectiveness. We have developed a new technique utilizing a brow incision with supraorbital trephination that allows introduction of an endoscope in the interhemispheric fissure and report here the effectiveness of endoscopic corpus callosotomy in a cadaveric and porcine model. This approach bypasses the conventional para sagittal approach and its attendant morbidity. [underline]Part 1[/underline]: 6 human cadaveric heads were secured in pins. A left midpupillary incision was made with medial retraction of the skin. A paramedian burr hole was made and a rigid endoscope inserted just lateral to the midline. The falx cerebri was followed until the genu of the corpus callosum was seen . The callosum was sectioned under endoscopic visualization. Brains were harvested and examined.
[underline]Part 2[/underline]: 5 male pigs were anesthetized and placed in the supine position with the head elevated 45 degrees. After a 1 cm midline skin incision a .5cm diameter hole was made. The rigid endoscope was inserted and advanced until the corpus callosum was visualized. The callosum was sectioned, animals euthanized and brains examined. [underline]Part 1[/underline]: All cadaveric transections of the corpus callosum were complete without injury to vascular structures. The supraorbital approach provided an adequate corridor to manipulate the angulation of the endoscope for complete visualization of the corpus callosum.[underline]Part 2[/underline]: The corpus callosum was readily transected in all specimens without vascular injury. All animals survived surgical intervention without new neurologic deficit.Video clips and photographs will be presented Endoscopic corpus callosotomy via a supraorbital approach is technically feasible and could offer an alternative approach that substantially reduces morbidity and hospitalization associated with conventional approaches