Total corpus callosotomy via posterior approach with endoscopic-alone technique

Two main surgical techniques are available for corpus callosotomy (CC): conventional microscopic CC; and endoscopic CC.1 Microscopic CC is more familiar to neurosurgeons and allows 3D visualization, but requires a larger craniotomy and has a narrower visual angle in the deep part. Endoscopic CC is a technique that has only recently been introduced to epilepsy surgery, but is gaining increasing interest among epilepsy surgeons. The endoscope provides 2D visualization and needs a camera as an additional instrument inserted into the surgical corridor. The merits of endoscopic CC include the smaller craniotomy and smaller skin incision, potentially reducing invasiveness.2 Bridging veins to the superior sagittal sinus are also less problematic because of the reduced need for brain retraction. Unnecessity of arachnoid dissection is another advantage.Generally, an anterior approach is applied for CC, but this approach makes interhemispheric fissure dissection mandatory especially at the cingulate gyri. In some cases, this procedure can take a long time. On the other hand, a posterior approach needs less interhemispheric arachnoid dissection, or even none at all, due to the anatomy of the falx cerebri. These reasons have driven the development of a posterior approach for an endoscopic-alone technique.3 Here, we presented a 5-year-old girl with medically intractable epileptic spasms diagnosed as IESS, who underwent endoscopic total CC via posterior approach to control her seizures.