Endoscopic Anatomy of the Transcallosal Hemispherotomy: A Cadaver Study With Advanced 3D Modeling

Transcallosal hemispherotomy is a surgical procedure used to treat severe epileptic seizures from a single brain hemisphere. This procedure involves the disconnection of the affected hemisphere from the rest of the brain, effectively preventing the spread of epileptic activity and reducing the frequency and severity of seizures. Endoscopic anatomy plays a crucial role in transcallosal hemispherectomy, as it allows for a minimally invasive approach. Using endoscopic techniques, surgeons can access and visualize the corpus callosum, a thick bundle of nerve fibers connecting the two cerebral hemispheres. This technique provides a clear view of the anatomical landmarks and enables precise disconnection of the affected hemisphere, while preserving critical neural structures. In this chapter, the authors review the endoscopic anatomy relevant to the transcallosal hemispherectomy identification of the corpus callosum's rostrum, genu, body, and splenium. By carefully navigating through these structures, surgeons can safely sever the connections between the affected and healthy hemispheres. This disconnection allows for better seizure control and improved quality of life for patients with severe epilepsy. The use of an endoscopic technique for transcallosal hemispherectomy may enable neurosurgeons to employ a minimally invasive approach to accomplish a precise disconnection of the affected hemisphere. It may thus form the basis for improved patient outcomes.