Minim Invasive Neurosurg 2009; 52(1): 9-16
DOI: 10.1055/s-0028-1103305
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Minimally Invasive Cerebral Cavernoma Surgery using Keyhole Approaches – Solutions for Technique-related Limitations

A. T. Stadie 1 , R. Reisch 2 , R. A. Kockro 1 , G. Fischer 1 , E. Schwandt 1 , S. Boor 3 , P. Stoeter 3
  • 1Neurochirurgische Klinik und Poliklinik der Johannes Gutenberg-Universität Mainz, Mainz, Germany
  • 2Neurochirurgische Klinik Universitätsspital Zürich, Zürich, Switzerland
  • 3Institut für Neuroradiologie der Johannes Gutenberg-Universität Mainz, Mainz, Germany
Further Information

Publication History

Publication Date:
26 February 2009 (online)


Cavernomas are often small in size and located in difficultly accessible regions. Preoperative identification of the ideal surgical approach as well as the precise intraoperative implementation of the surgical plan are of critical importance for successful surgery. While aiming for minimally invasive surgical techniques and maximally effective cavernoma resection, we envisaged that employing a combination of precise and technically sophisticated virtual reality surgery planning, modern navigation systems with augmented reality features and endoscope-assisted surgical techniques should contribute to achieve this goal. Between December 2002 and November 2005, 66 patients were operated on for cerebral cavernomas in our department. In 23 cases surgery planning was done by using a virtual reality planning system, neuronavigation was used in 43 cases and the intraoperative augmented reality feature was used in 16 cases. 10 patients were operated by using the endoscopic assisted surgical technique. Complete resection was achieved in all cases. Using all nowadays available surgical tools, cerebral cavernomas can be operated with minimally invasive techniques and with excellent results.



A. T. Stadie, MD 

Neurochirurgische Klinik und Poliklinik

Johannes Gutenberg-Universität Mainz

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