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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

The application of the waterjet dissector in tumours close to or within eloquent areas: results in 29 procedures

Die Applikation des Wasserstrahldissektors bei Tumoren im eloquenten Cortex: Ergebnisse mit 29 Operationen

Meeting Abstract

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  • corresponding author J. Oertel - Klinik für Neurochirurgie, Krankenhaus Hannover Nordstadt, Klinikum Hannover
  • H. Schroeder - Klinik für Neurochirurgie, Ernst-Moritz-Arndt-Universität, Greifswald
  • J. Piek - Abteilung für Neurochirurgie, Universität Rostock
  • M. Gaab - Klinik für Neurochirurgie, Krankenhaus Hannover Nordstadt, Klinikum Hannover

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc09.05.-17.09

The electronic version of this article is the complete one and can be found online at:

Published: May 4, 2005

© 2005 Oertel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



The waterjet instrument is under intense evaluation as a new minimally invasive tool for neurosurgery. Particularly, in eloquent areas a minimally traumatic approach is of particular importance.

Between August 1998 and December 2004, the waterjet device was applied in 29 cases of tumours close or within eloquent areas. The tumours consisted of 23 gliomas, 4 metastases and 2 meningiomas. In all cases, a neuronavigation system was applied. Intraoperatively, the general aspects of handling of the device, the extent of its application, and the quality and helpfulness for dissection and tumour aspiration as well as vessel preservation were monitored.

Tumours were localized in the premotor cortex in 21 cases, in Broca's area in 5, in Wernicke's area in 3 and in the insular region in 1 case. Waterjet pressures of 3 up to 12 bars were used with permanent suction. In all cases, the waterjet enabled precise tumour aspiration or dissection of the tumour from the brain. Under these pressures, vessels were preserved in all cases. Postoperative MRI revealed complete tumour resection in all cases (100%). There was no mortality. There was one case of brain abscess formation (3%). In 23 cases, the postoperative neurological status remained unchanged (79%). In 4 cases (14%), a transient neurological deterioration was observed. In 2 cases (7%), a permanent worsening of the patient's preoperative symptoms occurred.

The waterjet can be safely and - more important - very precisely applied in tumours in eloquent areas. No specific complications due to the waterjet device occurred. However, further data have to show that application of the device results in superior surgical results before the device can be considered an addition to the neurosurgical armamentarium for tumour resection in eloquent areas.