Abstracts

Rationale: We will present a novel endoscopic hemispherotomy (EH) and corpus callosotomy (ECC) using video clips. Methods: From 2011 to 2016, 6 hemispherotomies and 11 corpus callosotomies were done using a minimally-invasive technique with a suction attached to an endoscope. Patients' age ranged from 2.5 to 20 years. The last 5 procedures were done using a 3D endoscope. Four of the 6 patients who underwent EH had a neonatal stroke as the cause of intractable seizures, one had neonatal listeria meningitis, and another herpes simplex encephalitis. All except one of the 11 patients who underwent ECC had Lennox-Gastaut Syndrome. The etiology was unknown in 6; 2 had tuberous sclerosis complex (TSC), 1 with lissencephaly, 1 had remote brain injury and one was found to have inhibitory glycine receptor gene mutation. Results: The operative procedure was done through a 1-1.5 inch incision and a 3 cm craniotomy. The duration of surgery from incision to skin closure was 3.70.5 hours for ECC and 5.251.0 hours for EH. The mean blood loss was 72 cc, and none of the patients required a blood transfusion. The mean post-operative stay prior to the transfer to rehabilitation services was 4.7 days. In comparison, open hemispherectomy requires an incision about 10-12 inches long, has, on average, a blood loss of 340 ml and a postoperative hospital stay of 9.3 days. Over an average follow up of 1.5 years, amongst ECC 6 patients had class 1, 4 patients had class 2 and I patient had class 3 outcome. Amongst patients who underwent EH, 5 patients had a class 1 outcome and one patient with history of listeria meningitis had class 2 outcome. Conclusions: EH and ECC are feasible operations that can be performed through a small incision using the described technique with minimal blood loss, reduced postoperative stay, and effective seizure control. Funding: N/A