Resection of a craniopharyngioma using the "inside-out" technique: a two-dimensional operative video
- 1Department of Neurological Surgery, Center for Cranial Base Surgery, University of Pittsburgh Medical Center, Pittsburgh; and
- 2Department of Otolaryngology, Center for Cranial Base Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
Abstract
A 57-year-old man presented with headache and obstructive hydrocephalus caused by a craniopharyngioma. He underwent gross-total resection through an endoscopic endonasal approach. The key surgical concept was the "inside-out" technique, in which the tumor was internally decompressed first, allowing the capsule to collapse and the dissection plane to be developed gradually from the center of the lesion toward its peripheral pial interface. This helped limit traction on the optic apparatus, hypothalamus, and perforating vessels. Multilayer reconstruction was performed and assessed using indocyanine green fluorescence endoscopy. This video highlights the technical nuances of the inside-out technique for maximal safe resection of craniopharyngiomas.
The video can be found here: https://stream.cadmore.media/r10.3171/2026.7.FOCVID26115
Related
- Extended endoscopic endonasal resection of a transinfundibular craniopharyngioma with third ventricular extension associated with superficial siderosis: Operative technique and technical nuances.
- Extended endoscopic endonasal transplanum transtuberculum approach for retrochiasmatic type II transinfundibular craniopharyngioma: operative pearls and nuances of the technique.
- Anterior transpetrosal approach for a recurrent craniopharyngioma in a pediatric patient: two-dimensional operative video
- Occipital interhemispheric transtentorial approach for microsurgical resection of a posterior fossa medulloblastoma: 2-dimensional operative video.
- Endoscopic lateral transorbital approach for resection of a recurrent middle cranial fossa epidermoid cyst: Two-dimensional operative video.
BibTeX
@article{chen2026resection,
title = {{Resection of a craniopharyngioma using the "inside-out" technique: a two-dimensional operative video}},
author = {Zhengyuan Chen and Benjamin J. Carnovale and Adway Gopakumar and Shovan Bhatia and Garret Choby and Eric W. Wang and Carl H. Snyderman and Georgios A. Zenonos},
journal = {Neurosurgical Focus: Video},
year = {2026},
month = oct,
doi = {10.3171/2026.7.focvid26115},
url = {https://doi.org/10.3171/2026.7.focvid26115},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Resection of a craniopharyngioma using the "inside-out" technique: a two-dimensional operative video
AU - Zhengyuan Chen
AU - Benjamin J. Carnovale
AU - Adway Gopakumar
AU - Shovan Bhatia
AU - Garret Choby
AU - Eric W. Wang
AU - Carl H. Snyderman
AU - Georgios A. Zenonos
PY - 2026
DA - 2026/10/01
JO - Neurosurgical Focus: Video
DO - 10.3171/2026.7.focvid26115
UR - https://doi.org/10.3171/2026.7.focvid26115
AB - A 57-year-old man presented with headache and obstructive hydrocephalus caused by a craniopharyngioma. He underwent gross-total resection through an endoscopic endonasal approach. The key surgical concept was the "inside-out" technique, in which the tumor was internally decompressed first, allowing the capsule to collapse and the dissection plane to be developed gradually from the center of the lesion toward its peripheral pial interface. This helped limit traction on the optic apparatus, hypothalamus, and perforating vessels. Multilayer reconstruction was performed and assessed using indocyanine green fluorescence endoscopy. This video highlights the technical nuances of the inside-out technique for maximal safe resection of craniopharyngiomas. The video can be found here: https://stream.cadmore.media/r10.3171/2026.7.FOCVID26115
SN - 2643-5217
ER -