AB086. Retractor-less supraorbital approach for minimally exposed meningioma resections: a case report

BACKGROUND: The supraorbital keyhole approach is a frequently used approach for anterior skull base tumors such as meningiomas. This approach has emerged as a valuable technique in neurosurgery for its minimally invasive nature and direct access to intracranial lesions through a small eyebrow incision. Traditional approaches utilizing rigid retractors have been associated with soft tissue trauma and prolonged operative times. Recent innovations in retractor-less techniques and specialized micro instruments have been developed to improve surgical precision by reducing tissue disruption and enhancing patient outcomes. CASE DESCRIPTION: We present a series of 2 cases involving different patients with meningiomas located at the anterior skull base. All patients underwent tumor removal craniotomy using the supraorbital keyhole approach without the use of a retractor. Each patient had a short length of stay, better cosmetic outcomes, and fewer intraoperative and postoperative complications. This retractor-free approach also avoids damage to the blood vessels around the lesion, thereby minimizing intraoperative bleeding. CONCLUSIONS: Retractor-less supraorbital approaches represent a transformative advancement in neurosurgical practice, allowing for minimally exposed and precise tumor resections with favourable outcomes. Continued research and innovation in retractor less techniques are essential for refining surgical approaches, standardizing methodologies, and expanding the applicability of this method across various intracranial pathologies. The successful outcomes observed in our series underscore the potential of retractor less strategies to optimize patient care and enhance the surgical management of intracranial tumors.