Brain Access Systems Displace and Remove Subcortical Tissue

Two minimally invasive surgical devices facilitate the treatment of subcortical and skull base lesions, intraventricular tumors and cysts, and hemorrhagic stroke.

The NICO (Indianapolis, IN, USA) devices are designed to support minimally invasive parafascicular surgery (MIPS), and include BrainPath access sheathes for minimally disruptive access and the Myriad device for the automated tumor removal, collection, and biological preservation of brain tissue. BrainPath consists of a reusable, sterilizable obturator and a disposable sheath matched by friction fit. The sheath provides surgical access to the subcortical space using an approach parallel to brain fiber tracts, thus reducing the potential for tissue damage that may cause deficits after surgery.

After the creation of an appropriate craniotomy and the subsequent dural incision, the BrainPath sheath assembly is inserted into the brain tissue and advanced to the desired location, with depth bands placed on the obturator and sheath used as a visual reference during placement. Once the desired location has been reached, the sheath is advanced into position and the obturator removed. The sheath remains in the brain to serve as a protective portal that maintains access to the surgical site during tissue removal or fluid evacuation.

The Myriad system, an automated, multi-functional aspiration tool used for precise resection, suction, clot evacuation, and tumor removal can then be deployed to remove the diseased tissue. The Myriad system consists of a system console, handpieces, and ancillary products. All the handpieces have a side mouth cutting and aspiration aperture located just 0.6 mm from the blunt end, which allows for tissue removal without injury to adjacent structures. The NICO Myriad handpieces are available in 11, 13, 15, 17 and 19 gauges, and a variety of lengths.

“The goal of NICO has always been to create technology that could create less deficits and faster recoveries in brain surgery,” said Jim Pearson, president and CEO of NICO Corporation. “The clinical evidence shows this is possible, and we believe that is directly related to finding less disruptive ways to access the brain that were not possible before. And we believe it will revolutionize the intracranial neurosurgical market.”

“Brain metastases are the most common central nervous system neoplasms. In these selected patients, all lesions were subcortical and buried beneath important white matter tracts,” said Professor Jefferson Chen, MD, PhD, director of neurotrauma at the University of California Irvine (UCI, USA). “The fact that we were able to safely reach all locations speaks to the utility of the BrainPath and Myriad technologies. Careful attention to the application of BrainPath allows one to reach subcortical tumors and remove them using the Myriad in a minimally disruptive manner.”

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