Background/Objectives: 5-aminulevulinic acid (5-ALA)-guided surgery for high-grade gliomas remains a challenge in neuro-oncological surgery. Inconsistent fluorescence visualisation, subjective quantification and false negatives due to blood, haemostatic agents or optical impediments from the external light source are some of the limitations of the present technology. Methods: The preliminary results from this single-centre retrospective study are presented from the first 35 patients operated upon with the novel Nico Myriad Spectra System©. The microdebrider (Myriad) with an additional in situ light system (Spectra) can alternately provide white and blue light (405 nm) to within 15 mm of the tissue surface to enhance the morphology of the anatomical structures and the fluorescence of the pathological tissues. Results: A total of 35 patients were operated upon with this new technology. Eight patients (22.85%) underwent tubular retractor-assisted minimally invasive parafascicular surgery (tr-MIPS). The majority had high-grade gliomas (68.57%). Fluorescence was identified in 30 cases (85.71%), with residual fluorescence in 11 (36.66%). The main applications were better white–blue light alternation and visualisation during tr-MIPS, increase in the extent of resection at the border of the cavity, identification of satellite lesions in multifocal pathology, the differentiation between radionecrosis and tumour recurrence in redo surgery and the demarcation between normal ependyma versus pathological ependyma in tumours infiltrating the subventricular zone. Conclusions: This proof-of-concept study confirms that the novel in situ light-source delivery technology integrated with the usual intraoperative armamentarium provides a spatially, functionally and oncologically informed framework for glioblastoma surgery. It allows for the enhancement of the morphology of anatomical structures and the fluorescence of pathological tissues, increasing the extent of resection and, possibly, the prognosis for patients with high-grade gliomas.

We present a case of an unusually large, circumferential tubulovillous adenoma involving the terminal ileum and the caecum with ileocaecal valve consumption, presenting as intussusception in an otherwise healthy 90-year-old woman. The patient presented with several months of chronic symptoms of weight loss and diarrhoea. Clinical examination revealed a right-sided mass. Investigations revealed a large right-sided lesion suspicious of intussusception. The patient underwent a right-sided hemicolectomy where the intussusception was resected. Histology of the resected mass revealed a tubulovillous adenoma with focal invasive adenocarcinoma.

Intracranial dermoid cysts are benign lesions that may be diagnosed incidentally or present symptomatically due to mass effect—focal neurological deficits, seizures and/or hydrocephalus—or chemical meningitis secondary to spontaneous rupture. The use of tubular retractors in minimally invasive parafascicular surgery (tsMIPS) has been described extensively as a technique to preserve neurological function whilst safely maximizing the extent of resection. The authors present the first use of the tsMIPS approach for removal of a dermoid cyst in a 68-year-old female who presented with abulia and seizures due to a large Sylvian fissure dermoid cyst. This approach minimized trauma to surrounding cortical–subcortical structures, as supported by connectome analyses, without sacrificing visualization of the operative field. Additionally, itavoided manipulation of the lenticulostriate arteries attached to the walls of the dermoid cyst. The use of an endoscope ensured complete drainage of the cyst components and therefore the effectiveness of the procedure.