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. 2023 Jul 11:10:1214290.
doi: 10.3389/fsurg.2023.1214290. eCollection 2023.

Use of a neuro-evacuation device for the endoscopic removal of third ventricle colloid cysts

Stefano Peron  1 , Nicola Galante  1 , Donato Creatura  2 , Giovanni Marco Sicuri  1 , Roberto Stefini  1
Affiliations

Use of a neuro-evacuation device for the endoscopic removal of third ventricle colloid cysts

Stefano Peron et al. Front Surg. .

Abstract

Background: Colloid cysts are benign tumors usually located at the level of the foramen of Monro and account for approximately 1% of all intracranial tumors. Endoscopic surgical treatment represents the approach of choice for removal of these tumors and is usually preferred over transcortical or transcallosal microsurgical approaches. Our purpose is to demonstrate the feasibility of endoscopic removal of colloid cysts using a novel aspiration and fragmentation system, currently designed for evacuation of cerebral hematomas.

Methods: We performed an evaluation of the results obtained in patients with symptomatic colloid cysts of the third ventricle operated on using an endoscopic neuroevacuation system (Artemis Neuro Evacuation Device, Penumbra, Alameda, California, USA) between April 2020 and April 2022. Instrumentation and surgical technique are described in detail. All patients underwent postoperative MRI to assess the extent of cyst removal.

Results: Five patients were included in our study. The predominant symptom at onset was headache. No intraoperative complications related to the technology in use occurred. The surgical time for the cyst removal was significantly shorter than removal via a standard endoscopic technique (80 vs. 120 min). Removal was complete, both content and capsule of the cyst, in all patients. In all cases there was a complete regression of the previously complained symptoms.

Conclusion: The Artemis Neuro Evacuation Device has proved to be effective and safe in removal of colloid cysts of the third ventricle and may be proposed as a possible alternative or as a complement of the standard instruments routinely used in neuroendoscopy.

Keywords: Artemis; colloid cyst; endoscopic transforaminal approach; minimally invasive surgery; neuroendoscopy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The artemis neuro evacuation device; to note, the activation button with aspiration control hole on the handle.
Figure 2
Figure 2
The 2.8 mm cannula of the artemis device is introduced into the ventricle through the working channel of a rigid neuroendoscope.
Figure 3
Figure 3
Preoperative MRI images (axial and coronal T2-weighted, sagittal enhanced T1 weighted) showing the third ventricle colloid cyst with bilateral (left > right) ventriculomegaly (A–C); three-month postoperative MRI images showing complete removal of the cyst with marked reduction in ventricular size (D–F).
Figure 4
Figure 4
Preoperative MRI images (axial T2-weighted, coronal FLAIR T2-weighted, sagittal enhanced T1-weighted) showing the third ventricle colloid cyst with bilateral ventriculomegaly (A–C); 48 h postoperative MRI images showing complete removal of the cyst with initial reduction in ventricular size (D–F).
See this image and copyright information in PMC

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