Minimal access keyhole surgery for mesial temporal lobe epilepsy

A keyhole surgical approach for the treatment of medically intractable temporal lobe epilepsy is described. Additionally, patients who had keyhole surgery are contrasted with individuals who underwent a non-keyhole approach for outcome parameters of seizure freedom, complications, and speed of recovery. Patients who had a keyhole approach for temporal lobe epilepsy with over 2 years follow-up were compared with all patients who had selective amygdalohippocampectomy performed in a non-keyhole fashion over the same time period. Rates of seizure freedom were comparable in the 17 patients with keyhole surgery and the 34 individuals who had a non-keyhole approach. However, patients treated with keyhole surgery were discharged from the hospital earlier than non-keyhole patients (p = 0.04), and with a shorter operative time (p = 0.0001). The restricted keyhole surgical exposure has not limited the ability to perform surgery for temporal lobe epilepsy with favorable results on reducing the seizure tendency, and patients may be benefited by a minimal access technique with a more rapid recovery from surgery. (C) 2010 Published by Elsevier Ltd.