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CC BY-NC-ND 4.0 · Asian J Neurosurg 2025; 20(03): 572-580
DOI: 10.1055/s-0045-1809154
Original Article

Microscopic Resection of Intracranial Lesions with Tubular Retractor of Plastic Syringe: A Single-Center Experience of 157 Cases

Mohan Karki
1   Department of Neurosurgery, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India
,
Manish Vaish
1   Department of Neurosurgery, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India
,
Yaspal Singh Bundela
1   Department of Neurosurgery, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India
,
Hrishikesh Chakrabartty
1   Department of Neurosurgery, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India
,
Yam Bahadur Roka
2   Department of Neurosurgery, Gandaki Medical College, Pokhara, Nepal
,
Dipanshu Narula
1   Department of Neurosurgery, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India
,
Rakesh Pandey
1   Department of Neurosurgery, Max Super Speciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India
› Author Affiliations
Funding None.
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Abstract

Objective

Deeply located intracranial lesions such as intraparenchymal and intraventricular lesions are surgically challenging and associated with unavoidable complications such as seizure, surgical bed hematoma, and brain contusion caused by traction. The objective of this study is to evaluate the safety and effectiveness of the microscopic tubular retractor of a plastic syringe for the resection of deeply located brain lesions.

Materials and Methods

We retrospectively studied 157 patients with deep-seated intracranial lesions who underwent microscopic resection with the help of a tubular retractor made of a plastic syringe and Teflon introducer between January 2018 and January 2024 in a tertiary hospital. All deep-seated lesions were such as neurocytoma, lymphoma, ependymoma, colloid cysts, metastatic brain tumors, astrocytoma, and meningiomas. We evaluated all patients postoperatively with computed tomography (CT) scan on the first/second day of surgery. The amount of blood loss, the complications, and the mortality rate were recorded.

Results

There were 104 males and 53 females with a mean age of 54.13 (range: 15–80) years. Gross total resection was obtained in 85.35% and subtotal in 14.65% of patients. Complications such as surgical bed hematoma in 5.73%, seizure in 3.18%, weakness in 2.54%, and contusion in 3.82% of patients were noted. The blood loss varied from 30 to 500 mL (average, 100 mL). The mortality rate was observed in 2.54% of all patients. Follow-up ranged from 1 to 25 months (average, 10 months).

Conclusion

Plastic syringe tubular retractor with Teflon introducer system is safe and effective for the treatment of deeply located intracranial lesions in terms of low morbidity and excellent rate of resection.

Keywords

deeply located - intracranial lesions - plastic syringe - tubular retractor - outcome

Authors' Contributions

M.K. conceived and designed the study, collected data, and wrote and drafted the manuscript. M.V., Y.S.B., H.C., Y.B.R., D.N., and R.P. were responsible for editing and providing technical feedback on design and analyses.


Ethical Approval

This is a retrospective study, so informed consent was taken from the involved participants in this study. This study was approved by the Local Ethics Committee of the Max Super Specialty Hospital.


Data Availability Statement

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.


Patients' Consent

We declare that all patients gave informed consent prior to inclusion in this study.




Publication History

Article published online:
16 May 2025

© 2025. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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