Multimodality, Multidirectional Resection of Craniopharyngioma: Versatility in Alternating the Principal and Auxiliary Surgical Corridors and Visualization Modalities

Multidirectional approaches to large tumors can be considered less invasive if the surgical corridors are combined in a way to minimize traction forces on both brain and tumor and maximize visualization and protection of critical structures. These combination approaches can be made simpler with the seamless integration of the endoscope and microscope. The choice between the principal and auxiliary corridors should alternate just as smoothly as the visual modality and must be dictated by the anatomy and minute-to-minute tactical situation during the operation.