Minimally Invasive Resection of Intracranial Tumors Using the Aurora Surgiscope System: A Single-Center Experience

BACKGROUND AND OBJECTIVES: – Minimally invasive tubular systems may improve outcomes in deep-seated and infiltrative brain tumor management by minimizing parenchymal disruption and surgical complications. We present the initial feasibility of using the Aurora Surgiscope System (Integra LifeSciences) for removal of deep-seated lesions with preliminary assessments of safety and effectiveness, emphasizing its advantages in visualization, ergonomics, and operability.METHODS: – We retrospectively analyzed data for our patients undergoing intracranial tumor resection approaches with the Aurora Surgiscope between July 2019 and August 2024. Demographics, comorbidities, procedural details, and outcomes were reviewed. Tumor volumes were measured preresection and postresection using 3-dimensional Slicer.RESULTS: – Seventeen patients (median age = 68 years [IQR: 50-74]; men = 70.6%) underwent resection for glioblastoma multiforme (GBM) (52.9%), cavernomas (23.5%), and other tumors. The median preresection lesion volume was 6.6 mL (IQR: 0.8-17.4) comprising 70.6% primary tumors. GBM cases (66.7% subcortical) had a median tumor volume of 10.8 mL (IQR: 0.7-17.6). For all cases, median surgical and anesthesia durations were 181 minutes (IQR: 170-250) and 290 minutes (IQR: 249-329), respectively. Estimated blood loss was 80 mL (IQR: 50-100). Gross total resection and near-total resection were achieved in 70.6% and 11.8%, respectively. For GBMs, surgical duration was 217 minutes (IQR: 170-268), anesthesia time 300 minutes (IQR: 249-329), and estimated blood loss 100 mL (IQR: 50-100). Gross total resection was achieved in 55.6% and near-total resection in 22.2%. Two subtotal resection cases (1 GBM) required reoperation. Two GBM patients experienced neurological complications. No tumor recurrences were observed for 254 days (IQR: 49-462); with GBMs, no recurrence occurred for 154 days (IQR: 28-178). Among 4 GBM recurrences, 1 patient whose recurrence was managed with radiosurgery succumbed to the GBM.CONCLUSION: – The Aurora Surgiscope System is a promising tool for minimally invasive tumor resection, resulting in considerable volumetric reduction, high resection success rates, and favorable survival outcomes. Our findings support its potential to advance minimally invasive subcortical (deep-seated) intracranial tumor management.