Exo- and endoscopic lateral orbital wall approach for the medial temporal lobe glioma: how I do it

Background The endoscopic transorbital approach provides a direct access to the medial temporal lobe (MTL). However, when excising a highly vascular tumour, a wider access route that enables the concurrent use of standard neurosurgical instruments with both hands is preferable. Method We described the concept and technique of the lateral orbital wall approach (LOWA), which comprises orbitotomy and mini-craniotomy to treat MTL lesions using an exoscope and endoscope. Conclusion The LOWA provides a safe and natural surgical corridor to the MTL and enables 2- or 3-hand surgery. Hence, LOWA can potentially improve safety and efficiency to treat MTL lesions.