title: Pure endoscopic removal of pineal region tumors.
abstract: OBJECTIVE
  Endoscopic resection of pineal tumors using an endoscope with a mounted rigid suction that allows bimanual handling of the tumor for resection. This contrasts to the established method of biopsy of pineal tumors through intraventricular approach.
  
  
  METHODS
  Two patients, one with a cystic lesion in the pineal region and one with a large pineal tumor, were operated in sitting position through a subtorcular approach. Endoscope was held in the left hand with suction tip extending beyond the tip through its instrument channel. Regular microsurgical instrumentation/CUSA/Nico Aspirator was used with the right hand for dissection, cutting, and removing the tumor under endoscopic vision.
  
  
  RESULTS
  Surgeon comfort was superior to when microscope is used in sitting position. Complete resection was achieved in all cases.
  
  
  CONCLUSIONS
  The two-handed endoscopic technique using a mounted suction on the endoscope as described is a safe and effective strategy for resecting pineal region tumors.
authors: Department of Pediatric Neurosurgery, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, 48201, USA. ssood@med.wayne.edu
authors: Sandeep
authors: S
authors: Sood
authors: Mark
authors: M
authors: Hoeprich
authors: Steven D
authors: SD
authors: Ham
references: Neurosurgery. 2008 Mar;62(3 Suppl 1):108-9; discussion 109
references: 18424974
references: Childs Nerv Syst. 2010 Jul;26(7):953-5
references: 20393851
references: Neurosurgery. 2010 Sep;67(3 Suppl Operative):ons159-65
references: 20679933