Abstracts

Rationale: The art of surgery in corpus callosotomy is well established in the last several decades, and we have been performing numbers of callosotomy surgeries with vertical head fixed position. This fixation may require, however, brain retraction with retractors. Horizontal interhemispheric approach is reported in the vascular surgery.   Methods: 4 pin fixation with Sugita head frame is used in our intraoperative rotation technique to enable both vertical fixation at craniotomy and then horizontal fixation at callosotomy with microscope with ease. The patients are investigated that they have no cervical spondylosis. Surgeons and anesthesiologist do simulation after fixation, to see if (1) head frame rotation (2) tilting operation table, will be safely performed. The Sugita frame is fixed obliquely with the vertical head position at craniotomy, then rotated at the beginning of microscopic procedure to get horizontal position. A surgeon moves his position laterally to face with the interhemispheric spaces perpendicularly at this time. In anterior callosotomy and in total callosotomy, patients were supine positioned, while in posterior callosotomy, patients were prone positioned.  Results: 60 degrees rotation was easily realized in our method, and even 30 degrees rotation realized enough gravity control, either with a use of one retractor or without it. Horizontal interhemispheric approach gives us a good working spaces at callosotomy.  Conclusions: This method with brain gravity control enables both sure craniotomy procedure and safe callosotomy procedure with less brain retraction in callosotomy surgery.   Funding: None