Newer Technique of Using Indigenous Tubular Retractor (Tailored 5-mL Syringe) for Microscopic Excision of Third Ventricular Colloid Cysts

Abstract

Colloid cysts are benign space-occupying lesions that account for 0.5% to 1.0% of brain tumors and arise from the velum interpositum or the choroid plexus of the third ventricle. We are describing a modified surgical technique that combines the positive attributes of being minimalistic while retaining the effectiveness of microsurgery. In all 20 consecutive symptomatic patients with a preoperative magnetic resonance imaging diagnosis of colloid cyst who came to the senior author between 2008 and 2011 were included in the study. The patient was kept supine with the head positioned neutrally in the saggital plane and neck flexed at 20 degrees. The tube of a 5-mL plastic syringe having an external diameter of 13 mm and an internal diameter of 12.6 mm was cut towards the nozzle end to an appropriate length depending upon the cortical thickness measured on the preoperative magnetic resonance imaging. Microsurgical excision using tubular retractor was performed in all the cases. Average operative time was around 90 minutes with maximum of 120 minutes. None of the patients had seizures preoperatively or postoperatively and in all cases antiepileptic medication could be stopped after 3 to 6 months of surgery. Two patients had short-term memory impairment which returned to near-normal by 1 year after surgery.