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Licensed Unlicensed Requires Authentication Published by De Gruyter May 27, 2015

Part I: The challenge of functional preservation: an integrated systems approach using diffusion-weighted, image-guided, exoscopic-assisted, transulcal radial corridors

Amin B. Kassam, Mohamed A. Labib, Mohammed Bafaquh, Diana Ghinda, Joseph Mark, David Houlden, Melanie B. Fukui, Thanh Nguyen, Martin Corsten, Cameron Piron and Richard Rovin
From the journal Innovative Neurosurgery

Abstract

Surgical access to subcortical lesions in the sensorimotor area can lead to a high degree of cognitive and functional morbidity through injury to white matter fiber tracts. Inherent technological challenges limit resection of lesions in the sensorimotor area. A systematic and integrated approach to address these challenges termed the six-pillar approach has been developed. While individual elements of these pillars have been reported elsewhere, the authors hypothesize that the consistent adoption of standardized imaging, navigation, access, optics and resection technologies as a system identifies and protects eloquent tissue. In addition, this approach allows for the targeted harvest of viable cells to serve as the substrate for molecular regenerative therapy. An illustrative case with resection of a low-grade glioma in the sensorimotor region using the six-pillar approach is included to highlight the strengths of this approach.


Corresponding author: Amin B. Kassam, Aurora Neuroscience Innovation Institute, Neurosurgery, Aurora St. Luke’s Medical Center, Suite 630, 2801 West Kinnickinnic River Pkwy, Milwaukee, WI 53215, USA, Tel.: +1-414-385-1814, Fax: +1-414-385-1899, E-mail:

Acknowledgments

The authors are grateful to Gal Sela, Wes Hodges, and Dave Gallop for their technical assistance with the original manuscript

Conflict of interest disclosure: Dr. Kassam chairs the scientific advisory board for NICO Corporation. He holds equity stakes in Synaptive Medical and Regenerative Cell Sciences. Dr. Kassam received royalties from KLS Martin and serves as a consultant for Storz Corporation.

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The authors stated that there are no conflicts of interest regarding the publication of this article.


Supplemental Material

The online version of this article (DOI: 10.1515/ins-2014-0011) offers supplementary material, available to authorized users.


Received: 2014-10-29
Accepted: 2015-4-20
Published Online: 2015-5-27
Published in Print: 2015-6-1

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