Tubular retractors for deep-seated brain lesions

Deep-seated brain lesions encompass a variety of pathologies. The typical approach to these lesions involves sizeable craniotomies, extensive cortical and subcortical dissection, retraction with retractor blades, and microscopic dissection. This can be associated with significant morbidity. With advances in neuroimaging and surgical devices, the use of tubular retractors has provided a keyhole or minimally invasive approach for addressing pathologies located in eloquent locations below the cortical surface. The premise of this approach is that tubular retractors will splay rather than severe white matter tracts, expose the tumor surface, and provide a working channel for lesion dissection and removal. We will describe our experience with the use of different types of tubular retractors for accessing deep-seated brain lesions.