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Journal articles on the topic 'Endoscopic surgery'
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Serdar Karaca, Ahmet, M. Mahir Özmen, Ahmet Çınar Yastı, and Seher Demirer. "Endoscopy in surgery." Turkish Journal of Surgery 37, no. 2 (June 1, 2021): 83–86. http://dx.doi.org/10.47717/turkjsurg.2021.000000576.
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In the last 20 years, there have been important developments in endoscopy. Initially, endoscopy was developed and used as a diagnostic tool. As new technology developed, these devices also became the basis for therapeutic maneuvers. In recent years, flexible endoscopes have been used to per- form procedures replacing traditional surgical approaches. Examples of this field are transanal minimally invasive surgery, natural orifice transluminal endoscopic surgery, endoscopic metabolic surgery and third space endoscopies. Throughout history, surgeons have played a vital role in the design and development of endoscopic techniques, procedures, and equipment. Surgeons continue to lead the advancement of endoscopy, make important contributions, and serve as role models for innovation.
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Mitchell, S., and C. Coulson. "Endoscopic ear surgery: a hot topic?" Journal of Laryngology & Otology 131, no. 2 (January 10, 2017): 117–22. http://dx.doi.org/10.1017/s0022215116009828.
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AbstractObjectives:To summarise published research investigating maximal temperatures associated with endoscopes used in otology. Possible thermal issues surrounding the use of endoscopes in middle-ear surgery are discussed, and recommendations regarding the safest ways to use endoscopes in endoscopic ear surgery are made.Methods:A non-systematic review of the relevant literature was conducted, with descriptive analysis and presentation of the results.Results:There are currently no reports of any temperature-related deleterious effects in patients having undergone endoscopic ear surgery. There is debate regarding heat issues in endoscopic ear surgery, with a limited body of work documenting potential negative impacts of middle-ear heat exposure from endoscopes. The diameter of endoscope, type of light source used, distance from endoscope tip and duration of exposure are highlighted potential factors for high temperatures in endoscopic ear surgery.Conclusion:There is a trend towards endoscopes being used routinely in ear surgery. Simple practice points are recommended to minimise potential thermal risks.
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Shrestha, B. L. "Endoscopic stapes surgery: How I do it?" Kathmandu University Medical Journal 19, no. 3 (September 30, 2021): 387–89. http://dx.doi.org/10.3126/kumj.v19i3.49745.
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The use of endoscope in the field of ear surgery has done the revolutionary changes. The optical advantage of endoscope helps the otologist to perform the stapes surgery very conveniently. The main advantage of the endoscope in stapes surgery over the microscope is; the better preservation rates of the chorda tympani nerve (CTN), minimal curetting of the outer attic wall, hence minimizing the iatrogenic injury to the CTN. Apart from that, the audiometric results following the endoscopic stapes surgery is comparable with the microscopic surgery. We had performed the stapes surgery with the rigid nasal endoscopes (Karl Storz) of 4-mm diameter and 18-cm length. Our preliminary results showed that transcanal endoscopic stapedotomy is a reliable and safe technique for the surgical management of otosclerosis.
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Tabaee, Abtin, Vijay K. Anand, Justin F. Fraser, Seth M. Brown, Ameet Singh, and Theodore H. Schwartz. "THREE‐DIMENSIONAL ENDOSCOPIC PITUITARY SURGERY." Operative Neurosurgery 64, suppl_5 (May 1, 2009): ons288—ons295. http://dx.doi.org/10.1227/01.neu.0000338069.51023.3c.
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Abstract OBJECTIVE We describe a novel 3-dimensional (3-D) stereoendoscope and discuss our early experience using it to provide improved depth perception during transsphenoidal pituitary surgery. METHODS Thirteen patients underwent endonasal endoscopic transsphenoidal surgery. A 6.5-, 4.9-, or 4.0-mm, 0- and 30-degree rigid 3-D stereoendoscope (Visionsense, Ltd., Petach Tikva, Israel) was used in all cases. The endoscope is based on “compound eye” technology, incorporating a microarray of lenses. Patients were followed prospectively and compared with a matched group of patients who underwent endoscopic surgery with a 2-dimensional (2-D) endoscope. Surgeon comfort and/or complaints regarding the endoscope were recorded. RESULTS The 3-D endoscope was used as the sole method of visualization to remove 10 pituitary adenomas, 1 cystic xanthogranuloma, 1 metastasis, and 1 cavernous sinus hemangioma. Improved depth perception without eye strain or headache was noted by the surgeons. There were no intraoperative complications. All patients without cavernous sinus extension (7of 9 patients) had gross tumor removal. There were no significant differences in operative time, length of stay, or extent of resection compared with cases in which a 2-D endoscope was used. Subjective depth perception was improved compared with standard 2-D scopes. CONCLUSION In this first reported series of purely 3-D endoscopic transsphenoidal pituitary surgery, we demonstrate subjectively improved depth perception and excellent outcomes with no increase in operative time. Three-dimensional endoscopes may become the standard tool for minimal access neurosurgery.
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Badr-El-Dine, Mohammed, Yasser G. Shewel, Ahmad A. Ibrahim, and Mohammed Khalifa. "Endoscope-assisted surgery: a major adjunct in cholesteatoma surgery." Egyptian Journal of Otolaryngology 29, no. 2 (April 2013): 66–70. http://dx.doi.org/10.7123/01.ejo.0000426391.27924.84.
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EnAbstract Objective The purpose of this study was to evaluate the role of middle-ear endoscopy in the effective control over cholesteatoma through visualizing hidden areas of the middle-ear cleft. Materials and methods A total of 60 ears with retraction pocket cholesteatoma were operated upon. They were subdivided into 40 cases operated upon using the canal wall up technique and another 20 cases operated upon using transcanal atticotomy. Endoscopically guided ear surgery was incorporated complementary to the microscope as a principal part in the procedure. Results The incidence of cholesteatoma in the facial recess that was visualized by the endoscope was 25% compared with 20% by the microscope, whereas the incidence of detection of cholesteatoma in the sinus tympani by the endoscope was 35% compared with 5% by the microscope. Cholesteatoma in the anterior epitympanic recess was detected by the endoscope in 10% of ears compared with 0% by the microscope. In this series, no morbidity or complication was encountered secondary to the use of endoscopes in the mastoid or the middle ear. Conclusion Endoscope-assisted ear surgery has many benefits in cholesteatoma surgery as endoscopy helps explore hidden areas of the middle-ear cavity with a much lesser requirement for surgical exposure and the need to drill healthy bone; therefore, effective control over the disease can be achieved, thus establishing the concept of functional endoscopic ear surgery.
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Denton, O., P. Brahmabhatt, J. Ahmed, and A. Sanu. "Three-dimensional versus two-dimensional endoscopes in anatomical orientation of the middle ear and in simulated surgical tasks." Journal of Laryngology & Otology 136, no. 2 (January 10, 2022): 141–45. http://dx.doi.org/10.1017/s002221512200010x.
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AbstractBackgroundThree-dimensional endoscopes provide a stereoscopic view of the operating field, facilitating depth perception compared to two-dimensional systems, but are not yet widely accepted. Existing research addresses performance and preference, but there are no studies that quantify anatomical orientation in endoscopic ear surgery.MethodsParticipants (n = 70) were randomised in starting with either the two-dimensional or three-dimensional endoscope system to perform one of two tasks: anatomical orientation using a labelled three-dimensional printed silicone model of the middle ear, or simulated endoscopic skills. Scores and time to task completion were recorded, as well as self-reported difficulty, confidence and preference.ResultsNovice surgeons scored significantly higher in a test of anatomical orientation using three-dimensional compared to two-dimensional endoscopy (p < 0.001), with no significant difference in the speed of simulated endoscopic skills task completion. For both tasks, there was lower self-reported difficulty and increased confidence when using the three-dimensional endoscope. Participants preferred three-dimensional over two-dimensional endoscopy for both tasks.ConclusionThe findings demonstrate the superiority of three-dimensional endoscopy in anatomical orientation, specific to endoscopic ear surgery, with statistically indistinguishable performance in a skills task using a simulated trainer.
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Komatsu, Fuminari, Mika Komatsu, Tooru Inoue, and Manfred Tschabitscher. "Endoscopic Extradural Anterior Clinoidectomy via Supraorbital Keyhole: A Cadaveric Study." Operative Neurosurgery 68, suppl_2 (June 1, 2011): ons334—ons338. http://dx.doi.org/10.1227/neu.0b013e31821144e5.
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Abstract Background: Anterior clinoidectomy is an essential preliminary step for parasellar and pericavernous sinus surgery. Endoscopy is a widely accepted modality for neurosurgical strategies and is becoming more important in treating conditions involving the cranial base. Objective: To determine the feasibility of endoscopic extradural anterior clinoidectomy via the supraorbital keyhole. Methods: Eight fresh cadaver heads were studied using 4-mm, 0- and 30-degree rigid endoscopes to perform endoscopic extradural anterior clinoidectomy. We also evaluated a bony landmark for this technique in 36 dry craniums. Results: An endoscope was introduced into the extradural space created via a supraorbital keyhole craniotomy. The periorbita and the duplication of the dura extending to the temporal lobe dura and periorbita were exposed by drilling. Anterior clinoidectomy proceeded using a diamond drill under endoscopic visualization without a dural incision. A submerged view with continuous irrigation through an endoscopic sheath maintained clear visibility while drilling. A small bony eminence at the transition between the sphenoid ridge and the anterior clinoid process, which is an anatomic landmark for endoscopic extradural anterior clinoidectomy, was identified in 57.4% of 36 adult dry craniums. Conclusion: The endoscopic extradural procedure can accomplish reliable anterior clinoidectomy under superb endoscopic visualization. This method would be applicable to parasellar and cavernous sinus surgery combined with keyhole or conventional craniotomy.
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Peris-Celda, Maria, Leila Da Roz, Alejandro Monroy-Sosa, Takashi Morishita, and Albert L. Rhoton. "Surgical Anatomy of Endoscope-Assisted Approaches to Common Aneurysm Sites." Operative Neurosurgery 10, no. 1 (November 13, 2013): 121–44. http://dx.doi.org/10.1227/neu.0000000000000205.
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Abstract BACKGROUND: The endoscope is being introduced as an adjuvant to improve visualization of certain areas in open cranial surgery. OBJECTIVE: To describe the endoscopic anatomy of common aneurysm sites and to compare it with the microsurgical anatomy. METHODS: Pterional, anterior interhemispheric, and subtemporal approaches to the most common aneurysm sites were examined in cadaveric heads under the surgical microscope and with the endoscope. RESULTS: The endoscopic view, particularly with the angled endoscopes, provides a significant improvement compared with the microscopic view, especially for poorly visualized sites such as the medial aspect of the supraclinoid carotid artery and its branches, the area below the anterior perforated substance and optic tract, and the carotid and basilar bifurcations. The endoscope aided in the early visualization of perforating branches at each aneurysm site except the middle cerebral artery. Small-diameter optics (2.7 mm) provided greater space for dissection and less potential for tissue damage in narrow places, whereas the larger 4-mm diameter optics provided better visualization and less panoramic distortion. The positioning of the endoscope for each aneurysm site is reviewed. CONCLUSION: The endoscope provides views that complement or improve the microscopic view at each aneurysm site except the middle cerebral artery. Endoscopy training and a thorough knowledge of endoscopic vascular anatomy are essential to safely introduce endoscopic assistance in vascular surgery.
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Thomas, Roy F., William T. Monacci, and Eric A. Mair. "Endoscopic Image-Guided Transethmoid Pituitary Surgery." Otolaryngology–Head and Neck Surgery 127, no. 5 (November 2002): 409–16. http://dx.doi.org/10.1067/mhn.2002.129821.
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OBJECTIVE: We describe a new endoscopic transethmoid approach for pituitary surgery and to compare it with other surgical techniques. STUDY DESIGN AND SETTING: Eleven patients undergoing pituitary surgery from September 2000 through January 2002 underwent an image-guided endoscopic transethmoid procedure to remove pituitary tumors. Ease of approach, resection, exposure of the surgical field, and operative complications were documented. RESULTS: Endoscopic ethmoidectomy permits enhanced exposure and simplified tumor resection. The use of one nostril to stabilize the endoscope and the other to pass instruments affords a bimanual procedure that avoids the difficulty of small nares and keeping the scope fixed while exchanging instruments. Operative morbidity was low with no significant complications in this pilot study. CONCLUSIONS: This approach opens a generous operative exposure while safely allowing room to endoscopically maneuver and affords direct access should revision surgery be needed. SIGNIFICANCE: This procedure uses a technique familiar to otolaryngologists and may be used for pituitary and other skull base tumors. The transseptal approach to the sella turcica is the most commonly performed procedure to reach the pituitary gland. Three major variations of the transseptal approach are used: sublabial approach, external rhinoplasty approach, and transnasal approach. Each has unique advantages and disadvantages relative to each other and the endoscopic procedure, apart from the shared transseptal route ( Table 1 ). The techniques have been described elsewhere previously. 1–3 More recently, endoscopy has been used to aid the approach to the pituitary. The first endoscopic procedures used the transseptal dissection route through a standard sublabial incision, with the endoscope passed through a self-retaining speculum. 4–6 In other cases the endoscope was used for the approach only, with the binocular operating microscope subsequently used for the tumor resection. 7 Except for the wide field of vision afforded by the endoscopic approach, the morbidity of a transseptal dissection remained. More recent advances have used an endonasal approach, which allows the surgeon to bypass the transseptal dissection. 8–11 The majority of procedures performed use one nostril to pass the endoscope and other instruments, with limited endoscopic operative maneuverability. We introduce an endonasal transethmoid approach bypassing the need for a nasal retractor, headrest, and postoperative nasal packing, while providing enhanced endoscopic operative maneuverability through bimanual instrumentation using both nares and an endoscope stabilizer.
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Barkhoudarian, Garni, Alicia Del Carmen Becerra Romero, and Edward R. Laws. "Evaluation of the 3-Dimensional Endoscope in Transsphenoidal Surgery." Operative Neurosurgery 73, suppl_1 (February 12, 2013): ons74—ons79. http://dx.doi.org/10.1227/neu.0b013e31828ba962.
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Abstract BACKGROUND: Three-dimensional (3-D) endoscopy is a recent addition to augment the transsphenoidal surgical approach for anterior skull-base and parasellar lesions. We describe our experience implementing this technology into regular surgical practice. OBJECTIVE: Retrospective review of clinical factors and outcomes. METHODS: All patients were analyzed who had endoscopic endonasal parasellar operations since the introduction of the 3-D endoscope to our practice. Over an 18-month period, 160 operations were performed using solely endoscopic techniques. Sixty-five of these were with the Visionsense VSII 3-D endoscope and 95 utilized 2-dimensional (2-D) high-definition (HD) Storz endoscopes. Intraoperative and postoperative findings were analyzed in a retrospective fashion. RESULTS: Comparing both groups, there was no significant difference in total or surgical operating room times comparing the 2-D HD and 3-D endoscopes (239 minutes vs 229 minutes, P = .47). Within disease-specific comparison, pituitary adenoma resection was significantly shorter utilizing the 3-D endoscope (surgical time 174 minutes vs 147 minutes, P = .03). These findings were independent of resident or fellow experience. There was no significant difference in the rate of complication, reoperation, tumor resection, or intraoperative cerebrospinal fluid leaks. Subjectively, the 3-D endoscope offered increased agility with 3-D techniques such as exposing the sphenoid rostrum, drilling sphenoidal septations, and identifying bony landmarks and suprasellar structures. CONCLUSION: The 3-D endoscope is a useful alternative to the 2-D HD endoscope for transnasal anterior skull-base surgery. Preliminary results suggest it is more efficient surgically and has a shorter learning curve. As 3-D technology and resolution improve, it should serve to be an invaluable tool for neuroendoscopy.
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Carniol, Eric T., Alejandro Vázquez, Tapan D. Patel, James K. Liu, and Jean Anderson Eloy. "Utility of Intraoperative Flexible Endoscopy in Frontal Sinus Surgery." Allergy & Rhinology 8, no. 2 (January 2017): ar.2017.8.0205. http://dx.doi.org/10.2500/ar.2017.8.0205.
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Background Surgical management of the frontal sinus can be challenging. Extensive frontal sinus pneumatization may form a far lateral or supraorbital recess that can be difficult to reach by conventional endoscopic surgical techniques, requiring extended approaches such as the Draf III (or endoscopic modified Lothrop) procedure. Rigid endoscopes may not allow visualization of these lateral limits to ensure full evacuation of the disease process. Methods Here we describe the utility of intraoperative flexible endoscopy in two patients with far lateral frontal sinus disease. Results In both cases, flexible endoscopy allowed confirmation of complete evacuation of pathologic material, thereby obviating more extensive surgical dissection. Conclusion In cases where visualization of the far lateral frontal sinus is inadequate with rigid endoscopes, flexible endoscopy can be used to determine the need for more extensive dissection.
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de Divitiis, Enrico. "Endoscopic Transsphenoidal Surgery." Neurosurgery 59, no. 3 (September 1, 2006): 512–20. http://dx.doi.org/10.1227/01.neu.0000227475.69682.77.
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Abstract THE TRANSSPHENOIDAL MIDLINE route represents the standard approach to the pituitary and sellar area and is used for more than 95% of surgical indications in this region. It is the least traumatic route to the sella turcica, it avoids brain retraction, and it provides excellent visualization of the pituitary gland and lesions related to that structure. The technique has essentially replaced craniotomy and has been used by every pituitary neurosurgeon, representing the “gold standard” of the transsphenoidal approach to the sellar region for more than 30 years. The introduction of endoscopic techniques has produced a “stone-in-the-pond” effect, influencing the relatively peaceful neurosurgical environment. The brilliant increased vision of the surgical target offered by the endoscope can allow more effective removal of the lesion, followed by superior clinical results and a reduction in the incidence of complications. Endoscopy contributes to better and more contemporary knowledge of the possibilities of the transsphenoidal approach, thus increasing the extended approaches, not only for the pituitary area. Whether or not the transsphenoidal approach should be performed with the use of the microscope or the endoscope is finally discussed.
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Boese, A., M. Detert, Chr Stibbe, M. Thiele, and Chr Arens. "“Hands free for intervention”, a new approach for transoral endoscopic surgery." Current Directions in Biomedical Engineering 1, no. 1 (September 1, 2015): 157–59. http://dx.doi.org/10.1515/cdbme-2015-0039.
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AbstractA standard method for transoral diagnostic and dissection of tumour is the endoscopic examination plus microscopic and laser supported surgery. For endoscopic examination a set of rigid endoscopes with different angles of view are on the market and in use. To simplify the diagnostic examination, a first idea was to use an endoscope with flexible angles of view. A further step of this approach is the electrical angulation of the endoscopic view to enable an adaption on the surgery site without using the hands. Thus the hands are free for intervention. This paper shows a first implementation of a prototype of an electrical operated endoscope for a free hand imaging in transoral interventions.
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McLaughlin, Nancy, Amy A. Eisenberg, Pejman Cohan, Charlene B. Chaloner, and Daniel F. Kelly. "Value of endoscopy for maximizing tumor removal in endonasal transsphenoidal pituitary adenoma surgery." Journal of Neurosurgery 118, no. 3 (March 2013): 613–20. http://dx.doi.org/10.3171/2012.11.jns112020.
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Object Endoscopy as a visual aid (endoscope assisted) or as the sole visual method (fully endoscopic) is increasingly used in pituitary adenoma surgery. Authors of this study assessed the value of endoscopic visualization for finding and removing residual adenoma after initial microscopic removal. Methods Consecutive patients who underwent endoscope-assisted microsurgical removal of pituitary adenoma were included in this study. The utility of the endoscope in finding and removing residual adenoma not visualized by the microscope was noted intraoperatively. After maximal tumor removal under microscopic visualization, surgeries were categorized as to whether additional tumor was removed via endoscopy. Tumor removal and remission rates were also noted. Patients undergoing fully endoscopic tumor removal during this same period were excluded from the study. Results Over 3 years, 140 patients (41% women, mean age 50 years) underwent endoscope-assisted adenoma removal of 30 endocrine-active microadenomas and 110 macroadenomas (39 endocrine-active, 71 endocrine-inactive); 16% (23/140) of patients had prior surgery. After initial microscopic removal, endoscopy revealed residual tumor in 40% (56/140) of cases and the additional tumor was removed in 36% (50 cases) of these cases. Endoscopy facilitated additional tumor removal in 54% (36/67) of the adenomas measuring ≥ 2 cm in diameter and in 19% (14/73) of the adenomas smaller than 2 cm in diameter (p < 0.0001); additional tumor removal was achieved in 20% (6/30) of the microadenomas. Residual tumor was typically removed from the suprasellar extension and folds of the collapsed diaphragma sellae or along or within the medial cavernous sinus. Overall, 91% of endocrine-inactive tumors were gross-totally or near-totally removed, and 70% of endocrine-active adenomas had early remission. Conclusions After microscope-based tumor removal, endoscopic visualization led to additional adenoma removal in over one-third of patients. The panoramic visualization of the endoscope appears to facilitate more complete tumor removal than is possible with the microscope alone. These findings further emphasize the utility of endoscopic visualization in pituitary adenoma surgery. Longer follow-ups and additional case series are needed to determine if endoscopic adenomectomy translates into higher long-term remission rates.
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Tateya, Ichiro, Shuko Morita, Makiko Funakoshi, Tomomasa Hayashi, Seiji Ishikawa, Yo Kishimoto, Mami Morita, Shigeru Hirano, Morimasa Kitamura, and Manabu Muto. "Endoscopic Laryngo-Pharyngeal Surgery." Nihon Kikan Shokudoka Gakkai Kaiho 66, no. 5 (2015): 311–18. http://dx.doi.org/10.2468/jbes.66.311.
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HIKT, Yoshiki. "Endoscopic Surgery and Laser." JOURNAL OF JAPAN SOCIETY FOR LASER SURGERY AND MEDICINE 12, no. 3 (1991): 9–13. http://dx.doi.org/10.2530/jslsm1980.12.3_9.
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Schulz, Matthias, Georg Bohner, Hannah Knaus, Hannes Haberl, and Ulrich-Wilhelm Thomale. "Navigated endoscopic surgery for multiloculated hydrocephalus in children." Journal of Neurosurgery: Pediatrics 5, no. 5 (May 2010): 434–42. http://dx.doi.org/10.3171/2010.1.peds09359.
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Object Multiloculated hydrocephalus remains a challenging condition to treat in the pediatric hydrocephalic population. In a retrospective study, the authors reviewed their experience with navigated endoscopy to treat multiloculated hydrocephalus in children. Methods Between April 2004 and September 2008, navigated endoscopic procedures were performed in 16 children with multiloculated hydrocephalus (median age 8 months, mean age 16.1 ± 23.3 months). In all patients preoperative MR imaging was used for planning entry sites and trajectories of the endoscopic approach for cyst perforation and catheter positioning. Intraoperatively, a rigid endoscope was tracked by the navigation system. For all children the total number of operative procedures, navigated endoscopic procedures, implanted ventricular catheters, and drained compartments were recorded. In addition, postoperative complications and radiological follow-up data were analyzed. Results In 16 children, a total of 91 procedures were performed to treat multiloculated hydrocephalus, including 29 navigated endoscopic surgeries. Finally, 21 navigated procedures involved 1 ventricular catheter and 8 involved 2 catheters for CSF diversion via the shunt. The average number of drained compartments in a shunt was 3.6 ± 1.7 (range 2–9 compartments). In 9 patients (56%) a navigated endoscopic procedure constituted the last procedure within the follow-up period. One additional surgery was necessary in 3 patients (19%) after navigated endoscopy, and in 4 patients (25%) 2 further procedures were necessary after navigated endoscopy. Serial follow-up MR imaging demonstrated evidence of sufficient CSF diversion in all patients. Conclusions Navigated endoscopic surgery is a safe and effective treatment option for multiloculated hydrocephalus. The combination of the endoscopic approach and neuronavigation further refines preoperative planning and intraoperative orientation. The aim of treatment is to drain as many compartments as possible and as soon as possible, thereby establishing sufficient CSF drainage with few ventricular catheters in single shunt systems. Close clinical and radiological follow-up is mandatory because multiple revisions are likely.
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Fischer, Gerrit, Joachim Oertel, and Axel Perneczky. "Endoscopy in Aneurysm Surgery." Operative Neurosurgery 70, suppl_2 (September 20, 2011): ons184—ons191. http://dx.doi.org/10.1227/neu.0b013e3182376a36.
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ABSTRACT BACKGROUND: Surgical clipping with complete occlusion of the aneurysm and preservation of parent, branching, and perforating vessels remains the most definitive treatment for intracranial aneurysms. OBJECTIVE: To evaluate the benefit of endoscopic application during microsurgical procedures in a retrospective study. METHODS: One hundred eighty aneurysms were microsurgically treated in 124 operations. Three different applications of endoscopic visualization were used, depending on the respective requirements: inspection before clipping, clipping under endoscopic view, and postclipping evaluation. RESULTS: Of 1380 aneurysms, 292 procedures were done with application of the endoscope. Of these 292, a complete data set, including video recording of the procedures for retrospective evaluation, was available in 180 cases. In these, the endoscope provided a favorable enhancement of the visual field, particularly in complex or deep-seated lesions. No adverse effects were observed. Before clipping, the endoscope was used to gain additional topographic information in 150 of 180 cases (83%). Clipping under endoscopic view was performed in 4 cases. After clipping, endoscopic inspection was performed in 130 of 180 procedures. Depending on the endoscopic findings, rearrangement of the applied clip or additional clipping was found to be necessary in 26 of 130 cases (20.0%). CONCLUSION: Endoscopic enhancement of the visual field provided by the endoscope before, during, and after microsurgical aneurysm occlusion may be a safe and effective application to increase the quality of treatment. Although unexpected findings concerning completeness of aneurysm occlusion and compromise of involved vessels could be diminished by endoscopic assessment, total prevention was not accomplished.
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Komatsu, Fuminari, Masaaki Imai, Hideaki Shigematsu, Rie Aoki, Shinri Oda, Masami Shimoda, and Mitsunori Matsumae. "Endoscopic extradural supraorbital approach to the temporal pole and adjacent area: technical note." Journal of Neurosurgery 128, no. 6 (June 2018): 1873–79. http://dx.doi.org/10.3171/2017.3.jns162228.
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The authors’ initial experience with the endoscopic extradural supraorbital approach to the temporal pole and adjacent area is reported. Fully endoscopic surgery using the extradural space via a supraorbital keyhole was performed for tumors in or around the temporal pole, including temporal pole cavernous angioma, sphenoid ridge meningioma, and cavernous sinus pituitary adenoma, mainly using 4-mm, 0° and 30° endoscopes and single-shaft instruments. After making a supraorbital keyhole, a 4-mm, 30° endoscope was advanced into the extradural space of the anterior cranial fossa during lifting of the dura mater. Following identification of the sphenoid ridge, orbital roof, and anterior clinoid process, the bone lateral to the orbital roof was drilled off until the dura mater of the anterior aspect of the temporal lobe was exposed. The dura mater of the temporal lobe was incised and opened, exposing the temporal pole under a 4-mm, 0° endoscope. Tumors in or around the temporal pole were safely removed under a superb view through the extradural corridor. The endoscopic extradural supraorbital approach was technically feasible and safe. The anterior trajectory to the temporal pole using the extradural space under endoscopy provided excellent visibility, allowing minimally invasive surgery. Further surgical experience and development of specialized instruments would promote this approach as an alternative surgical option.
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Halpern, Casey H., Shih-Shan Lang, and John Y. K. Lee. "Fully Endoscopic Microvascular Decompression: Our Early Experience." Minimally Invasive Surgery 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/739432.
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Background. Microvascular decompression (MVD) is a widely accepted treatment for neurovascular disorders associated with facial pain and spasm. The endoscope has rapidly become a standard tool in neurosurgical procedures; however, its adoption in lateral approaches to the posterior fossa has been slower. The endoscope is used primarily to assist conventional microscopic techniques. We are interested in developing fully endoscopic approaches to the cerebellopontine angle, and here, we describe our preliminary experience with this procedure for MVD.Methods. A retrospective review of our two-year experience from 2011 to 2012, transitioning from using conventional microscopic techniques to endoscope-assisted microsurgery to fully endoscopic MVD, is provided. We also reviewed our preliminary outcomes during this transition.Results. There was no difference in the surgical duration of these three procedures. In addition, the majority of procedures performed in 2012 were fully endoscopic, suggesting the ease of incorporating this solo tool into practice. Pain outcomes of fully endoscopic MVD appear to be very similar to those of both conventional and endoscope-assisted MVDs. Complications occurred in all groups at equally low rates.Conclusion. Fully endoscopic MVD is both safe and effective. By enhancing visualization of structures within the cerebellopontine angle, endoscopy may prove to be a valuable adjunct or alternative to conventional microscopic approaches.
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Thapa, Amit, Bidur KC, and Bikram Shakya. "Minimal invasive endoscopic neurosurgery." Journal of Society of Surgeons of Nepal 18, no. 3 (July 25, 2016): 54. http://dx.doi.org/10.3126/jssn.v18i3.15316.
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Introduction and Objective: If microscope heralded a new era in delicate and precise neurosurgical procedures, endoscope introduced an element of minimal invasiveness and supplemented microscope where they could not reach. We introduced and have been improving this art in brain and spine surgery and here present our experiences.Materials and Methods: We retrospectively studied patients who underwent endoscopic neurosurgery since July 2014 till January 2016 for brain and spine diseases. Endpoints for the audit were feasibility, reliability, cost effectiveness, extra time taken and morbidity.Results: We used endoscope in 42 cases. Ventriculoscopy was done for endoscopic third ventriculostomy, septoplasty, cyst aspiration and excision and biopsy. Nasal endoscopy was used to excise pituitary tumor and repair skull base CSF leaks. Spinal endoscopy was performed to remove herniated discs and canal stenosis. Endoscope helped in microscopic excision of acoustic schwannoma as well as craniopharyngioma. We did not have any mortality however CSF leaks were seen which was successfully managed. Since endoscopic procedures involve minimal incision and retraction, patients could be discharged early and mobilised. We discuss our learning phase and limitations of the endoscope with videos and case scenarios.Conclusion: A continuous phase of learning and problem solving is required to master the art of minimal invasive neurosurgery. Use of endoscope not only supplemented microscope but in cases of ventricular surgery is beyond comparison. It has minimised morbidity as well as hospital stay and is cosmetically acceptable to patients.
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KADER, R., P. Middleton, O. Ahmad, R. Dart, J. McGuire, G. Sebepos-Rogers, J. Segal, E. Shakweh, and M. Samaan. "P225 Using a standardised reporting proforma is associated with improved endoscopic assessment in UC." Journal of Crohn's and Colitis 14, Supplement_1 (January 2020): S255. http://dx.doi.org/10.1093/ecco-jcc/jjz203.354.
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Abstract Background Repeated endoscopic assessments are an essential part of ulcerative colitis (UC) disease management and current guidelines recommend the use of an endoscopic activity score, either the endoscopic Mayo score or Ulcerative Colitis Endoscopic Index of Severity (UCEIS) as treatment targets. These indices have prognostic value, with endoscopic healing associated with favourable short- and long-term outcomes. This multi-centre study aimed to assess the frequency of using endoscopic disease activity scores in UC patients undergoing lower GI endoscopy. Methods Lower GI endoscopy reports from patients with UC were retrospectively reviewed from 7 sites in London between April and October 2018. Endoscopy reports were assessed based on the BRIDGe endoscopic reporting criteria including the use of Mayo or UCEIS score. The comparison was made between site factors (specialist IBD centres/non-specialist centres, use of reporting proforma), endoscopist speciality (gastroenterology, surgery or nurse endoscopist), level of training (consultant, registrar or nurse endoscopist) and interest in IBD. Chi-squared was used to compare groups. Results 899 lower GI endoscopy reports were reviewed. Mayo or UCEIS was used in 51% of cases (453/899). The use of endoscopic scores were significantly higher in gastroenterologists than in surgeons and nurse endoscopists respectively (401/762 (53%) vs. 22/54 (41%) vs. 30/83 (36%)), and higher in registrar trainees than consultants and nurse endoscopists (175/251 (70%) vs. 248/565 (44%) vs. 30/83 (36%)) and in those with a specialist interest in IBD compared with those without (237/409 (58%) vs. 216/490 (44%), p < 0.0001). The use of endoscopic scores was more frequent in specialist IBD centres than in non-specialist centres (417/728 (58%) vs. 36/172 (21%), p < 0.001). One centre used a reporting proforma which was associated with a significantly higher frequency of score use compared with centres without a proforma (202/260 (78%) vs. 251/639 (39%), p < 0.0001). Conclusion Reporting of endoscopic disease activity using a standardised scoring system occurs in only half of cases from this large multi-centre cohort. Frequency of use is higher in specialist IBD centres and when performed by gastroenterology specialists. Endoscopy reports from a site that used a standardised reporting proforma were significantly more likely to include an endoscopic index as well as a range of other reporting items. This suggests, at least in part, that endoscopy reporting may be optimised by the introduction of a proforma. Integration of a standardised proforma into reporting software would target all endoscopists performing UC endoscopies regardless of speciality, site or IBD interest.
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Sharma, Jitendra Kumar, Sushma Mahich, and Navneet Mathur. "A comparative study of endoscopic assisted versus conventional middle ear and mastoid surgery at a tertiary care teaching hospital." International Journal of Otorhinolaryngology and Head and Neck Surgery 8, no. 1 (December 23, 2021): 21. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20214823.
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<p><strong>Background:</strong> Objectives were to compare outcomes, intra operative visualization and operative time duration in endoscopic assisted vs conventional middle ear and mastoid surgery.</p><p><strong>Methods: </strong>This prospective comparative study was conducted in 50 patients; among them 25 cases were of endoscope assisted middle ear surgery and 25 cases with conventional microscopic middle ear surgery. A 4 mm diameter, 18 cm long rigid, zero-degree endoscope and operating microscope was used. Primary outcomes include mean average pre and post operative air-bone (A-B) gap, hearing thresholds, intra operative visualization and duration of surgery.<strong></strong></p><p><strong>Results: </strong>Mean A-B gap closure for endoscopic assisted tympanoplasty was 12.76±6.00 dB, while it was 8.38±5.78 dB for non-endoscopic assisted tympanoplasty. The results were comparative. Mean intra-operative time duration for endoscopic assisted tympanoplasty was 70.23±4.17 min, while it was 77±9.80 min for non-endoscopic assisted tympanoplasty with statically significant difference between both groups (p=0.03). Graft uptake rate for endoscopic assisted tympanoplasty was 92.31% while it was 84.62% for non-endoscopic assisted tympanoplasty. Residual cholesteatoma remnant on endoscopy was found in 43.66% cases out of 12 mastoidectomy cases performed via endoscopic assistance.<strong></strong></p><p><strong>Conclusions: </strong>The endoscope can be successfully applied to ear surgery for most of the ear procedures with a reasonable success rate both in terms of perforation closure and hearing improvement and with minimal exposure. Wide-field zero, 30 or 70° endoscope sallow visualization of hidden anatomic spaces and working around corners i.e., epitympanum, hypotympanum and retro tympanum for safe removal of cholesteatoma.</p>
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Luo, Xiongbiao, Kensaku Mori, and Terry M. Peters. "Advanced Endoscopic Navigation: Surgical Big Data, Methodology, and Applications." Annual Review of Biomedical Engineering 20, no. 1 (June 4, 2018): 221–51. http://dx.doi.org/10.1146/annurev-bioeng-062117-120917.
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Interventional endoscopy (e.g., bronchoscopy, colonoscopy, laparoscopy, cystoscopy) is a widely performed procedure that involves either diagnosis of suspicious lesions or guidance for minimally invasive surgery in a variety of organs within the body cavity. Endoscopy may also be used to guide the introduction of certain items (e.g., stents) into the body. Endoscopic navigation systems seek to integrate big data with multimodal information (e.g., computed tomography, magnetic resonance images, endoscopic video sequences, ultrasound images, external trackers) relative to the patient's anatomy, control the movement of medical endoscopes and surgical tools, and guide the surgeon's actions during endoscopic interventions. Nevertheless, it remains challenging to realize the next generation of context-aware navigated endoscopy. This review presents a broad survey of various aspects of endoscopic navigation, particularly with respect to the development of endoscopic navigation techniques. First, we investigate big data with multimodal information involved in endoscopic navigation. Next, we focus on numerous methodologies used for endoscopic navigation. We then review different endoscopic procedures in clinical applications. Finally, we discuss novel techniques and promising directions for the development of endoscopic navigation.
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Morita, Akio, Masahiro Shin, Laligam N. Sekhar, and Takaaki Kirino. "Endoscopic Microneurosurgery: Usefulness and Cost-effectiveness in the Consecutive Experience of 210 Patients." Neurosurgery 58, no. 2 (February 1, 2006): 315–21. http://dx.doi.org/10.1227/01.neu.0000195011.26982.5b.
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Abstract OBJECTIVE: Indications, usefulness, and cost-effectiveness of the endoscope in routine microneurosurgery are not clear. To delineate such aspects, we assessed our experience of endoscopic application and additional cost to use an endoscope. METHODS: Endoscopes were used in 210 patients with cranial base and cisternal pathological features in the previous 7 years. Lesions were located in the extradural cranial base in 78 patients and in the cistern in 132 patients. Rigid lens endoscopes 2.7 to 4 mm in width, 11 to 20 cm in length, and 0 to 70° in angle were used. RESULTS: Endoscopes were used for primary or a significant part of the surgery in 64% of the extradural cranial base procedures. Although endoscopes were used only for visual assistance in 82% of cisternal pathological features, significant benefit was noted in 9% and was not different from cranial base lesions. Eleven patients may have had complications if the endoscope had not been used, and 10 procedures would have been impossible without endoscopic use. Therefore, the number of patients need to treat to experience significant benefits by endoscope was 10. Endoscopic equipment costs an additional US $326 per patient and, hence, significant benefit was the equivalent of US $3260. No permanent complications resulted from the use of the endoscope. CONCLUSION: The endoscope can be applied safely in routine microsurgery with specific equipment and has proven useful in 1 of 10 patients. To perform more effective procedures using endoscopes, we need to develop specially designed instruments usable through a narrow corridor and in an angled field.
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Zappa, Francesca, Alba Madoglio, Marco Ferrari, Davide Mattavelli, Alberto Schreiber, Stefano Taboni, Erika Ferrari, et al. "Hybrid Robotics for Endoscopic Transnasal Skull Base Surgery: Single-Centre Case Series." Operative Neurosurgery 21, no. 6 (October 8, 2021): 426–35. http://dx.doi.org/10.1093/ons/opab327.
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Abstract BACKGROUND Only preclinical studies and case reports have described robotic surgery for endoscopic transnasal skull base surgery. OBJECTIVE To evaluate the role of a novel robotic endoscope holder, developed for transsphenoidal surgery. METHODS Patients were prospectively enrolled for 3 mo at the Neurosurgery Unit of Brescia. Endoscope Robot® was used to assist during the sphenoidal phase of the approach, tumor removal, and skull base reconstruction. A Likert scale questionnaire was given to all surgeons after each procedure. Patients who underwent robotic-assisted surgery were matched with nonrobotic ones for pathology and type of procedure. All surgical videos were evaluated during bimanual phases. RESULTS Twenty-one patients underwent robot-assisted, endoscopic transsphenoidal surgery for different pathologies (16 pituitary adenomas, 3 chordomas, 1 craniopharyngioma, 1 pituitary exploration for Cushing disease) for a total of 23 procedures (1 patient underwent 2 endoscopic revisions of a skull base reconstruction). Subjective advantages reported by surgeons included smoothness of movement, image steadiness, and improvement of maneuvers in narrow spaces and with angled endoscopes; as the main limitation, Endoscope Robot® appeared to be relatively heavy during the initial endoscope positioning. A comparative analysis with a historical matched cohort documented similar clinical outcomes, while endoscope lens cleaning and position readjustments were significantly less frequent in robotic procedures. CONCLUSION Although confirmation in larger studies is needed, Endoscope Robot® was a safe and effective tool, especially advantageous in lengthy interventions through deep and narrow corridors.
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Kim, Sang-Hyun, Hyuk-Soon Choi, Bora Keum, and Hoon-Jai Chun. "Robotics in Gastrointestinal Endoscopy." Applied Sciences 11, no. 23 (November 30, 2021): 11351. http://dx.doi.org/10.3390/app112311351.
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Recent advances in endoscopic technology allow clinicians to not only detect digestive diseases early, but also provide appropriate treatment. The development of various therapeutic endoscopic technologies has changed the paradigm in the treatment of gastrointestinal diseases, contributing greatly to improving the quality of life of patients. The application of robotics for gastrointestinal endoscopy improves the maneuverability and therapeutic ability of gastrointestinal endoscopists, but there are still technical limitations. With the development of minimally invasive endoscopic treatment, clinicians need more sophisticated and precise endoscopic instruments. Novel robotic systems are being developed for application in various clinical fields, to ultimately develop into minimally invasive robotic surgery to lower the risk to patients. Robots for endoscopic submucosal dissection, autonomous locomotive robotic colonoscopes, and robotic capsule endoscopes are currently being developed. In this review, the most recently developed innovative endoscopic robots were evaluated according to their operating mechanisms and purpose of use. Robotic endoscopy is an innovative treatment platform for future digestive endoscopy.
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Kanczok, Thomas, Gerrit Fischer, Sebastian Senger, and Stefan Linsler. "Endoscopic-Assisted Microsurgical Meningioma Resection in the Skull Base via Minicraniotomy: Is There a Difference in Radicality and Outcome between Anterior Skull Base and Posterior Fossa?" Cancers 16, no. 7 (March 31, 2024): 1391. http://dx.doi.org/10.3390/cancers16071391.
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Background: Keyhole-based approaches are being explored for skull base tumor surgery; aiming for reduced complications while maintaining resection success rates. This study evaluates skull base meningiomas resected using an endoscopic-assisted microsurgical keyhole approach, comparing outcomes with standard procedures. Methods: Between 2013 and 2019; 71 out of 89 patients were treated using an endoscopic-assisted microsurgical procedure. A total of 42 meningiomas were localized at the anterior skull base and 29 in the posterior fossa. The surgical techniques and use of an endoscope were analyzed and compared in terms of complications, surgical radicality, outcome, and recurrences in the patients’ follow-up. Results: The two different cohorts yielded similar rates of GTR (anterior skull base: 80% versus posterior fossa: 82%). The complication rate was 31% for the posterior fossa and 16% for the anterior skull base. An endoscope was used in 79% of all cases. Tumor remnants were detected by means of endoscopic visualization in 58.6% of posterior fossa and 33% of anterior skull base meningiomas. The statistical analysis revealed significantly higher benefits from endoscope use in the posterior fossa cohort (p < 0.05). Conclusions: The results revealed that endoscopy was beneficial in both locations. The identification of remnant tumor tissue and the benefit of endoscopy were clearly higher in the posterior fossa. Endoscopic assistance is a very helpful tool for increasing radicality, providing a better anatomical overview during surgery, and better identifying remnant tumor tissue in skull base meningioma surgery.
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Molteni, Gabriele, Daniele Marchioni, Francesco Mattioli, Angelo Ghidini, Matteo Alicandri-Ciufelli, and Livio Presutti. "Endoscopic Management of Acquired Cholesteatoma." Otolaryngology–Head and Neck Surgery 139, no. 2_suppl (August 2008): P55. http://dx.doi.org/10.1016/j.otohns.2008.05.179.
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Objective The purpose of this study was to examine the utility of using an endoscope in cholesteatoma surgery and to demonstrate how it allows a reduction in the incidence of residual disease. Methods A prospective study. A total of 53 ears with acquired cholesteatoma (primary) were resected. 20 cases were resected using a canal wall up (CWU) technique, 6 cases using a canal wall down (CWD) technique, and in 27 cases a transcanal tympanotomyatticotomy was performed. All of the patients in our study group underwent an explorative and operative endoscopic ear surgery complementary to the operating microscope to uncover and remove residual cholesteatoma. Results In the primary surgery after completion of microscopic cleaning, the overall incidence of intraoperative residual disease detected with the endoscope was 37.5%. The sinus tympani was the most common site of intraoperative residuals, followed by the anterior epitympanic recess and protympanum. Out of the 20 CWU cases, 12 second-look endoscopies were performed. Two recurrences were identified, both in the sinus tympani. There were no significant complications associated with the 53 endoscopic procedures. Conclusions The endoscope allowed a better understanding of cholesteatoma and improved eradication of residual disease from hidden areas such as the anterior epitympanic recess, retrotympanum and hypotympanum not yet controllable by operating microscope.
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He, Yucheng, Ying Hu, Peng Zhang, Baoliang Zhao, Xiaozhi Qi, and Jianwei Zhang. "Human–Robot Cooperative Control Based on Virtual Fixture in Robot-Assisted Endoscopic Sinus Surgery." Applied Sciences 9, no. 8 (April 22, 2019): 1659. http://dx.doi.org/10.3390/app9081659.
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In endoscopic sinus surgery, the robot assists the surgeon in holding the endoscope and acts as the surgeon’s third hand, which helps to reduce the surgeon’s operating burden and improve the quality of the operation. This paper proposes a human–robot cooperative control method based on virtual fixture to realize accurate and safe human–robot interaction in endoscopic sinus surgery. Firstly, through endoscopic trajectory analysis, the endoscopic motion constraint requirements of different surgical stages are obtained, and three typical virtual fixtures suitable for endoscopic sinus surgery are designed and implemented. Based on the typical virtual fixtures, a composite virtual fixture is constructed, and then the overall robot motion constraint model is obtained. Secondly, based on the obtained robot motion constraint model, a human–robot cooperative control method based on virtual fixture is proposed. The method adopts admittance control to realize efficient human–robot interaction between the surgeon and robot during the surgery; the virtual fixture is used to restrain and guide the motion of the robot, thereby ensuring motion safety of the robot. Finally, the proposed method is evaluated through a robot-assisted nasal endoscopy experiment, and the result shows that the proposed method can improve the accuracy and safety of operation during endoscopic sinus surgery.
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Sheppard, Sean C., Marco D. Caversaccio, and Lukas Anschuetz. "Endoscopic and Robotic Stapes Surgery: Review with Emphasis on Recent Surgical Refinements." Current Otorhinolaryngology Reports 10, no. 1 (January 6, 2022): 34–39. http://dx.doi.org/10.1007/s40136-021-00380-4.
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Abstract Purpose of Review Stapes surgery has been established as the gold standard for surgical treatment of conductive hearing loss in otosclerosis. Excellent outcomes with very low complication rate are reported for this surgery. Recent advances to improve surgical outcome have modified the surgical technique with endoscopes, and recent studies report development of robotical assistance. This article reviews the use of endoscopes and robotical assistance for stapes surgery. Recent Findings While different robotic models have been developed, 2 models for stapes surgery have been used in the clinical setting. These can be used concomitant to an endoscope or microscope. Endoscopes are used on a regular base regarding stapes surgery with similar outcomes as microscopes. Endoscopic stapes surgery shows similar audiological results to microscopic technique with an advantage of less postoperative dysgeusia and pain. Its utility in cases of revision surgery or malformation is emphasized. Summary Endoscopic stapes surgery is used on a regular basis with excellent outcomes similar to the microscopic approach, while reducing surgical morbidity. Robotic technology is increasingly being developed in the experimental setting, and first applications are reported in its clinical use.
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Wojdas, Andrzej, and Roman Stablewski. "OWN EXPERIENCES IN THE APPLICATION OF INTRAOPERATIVE 3D SPATIAL IMAGING IN THE ENDOSCOPIC SURGERY OF THE PARANASAL SINUSES." Polish Journal of Aviation Medicine, Bioengineering and Psychology 26, no. 2 (March 30, 2023): 11–16. http://dx.doi.org/10.13174/pjambp.30.03.2023.02.
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Introduction: Intraoperative spatial imaging using a high-resolution 3D camera is a state-ofthe-art technique applied to endoscopic paranasal sinus surgery. It enables better visualization of the surgical site, improves depth perception and facilitates tissue identification. All 3D endoscopy capabilities are still under review. The purpose of this study is to compare analogous endoscopic surgeries performed with 3D technique and those performed with traditional 2D technique based on the analysis of length of surgery, blood loss, occurrence of intraoperative complications and hospital stay time. Material: The material included 346 patients who underwent endoscopic paranasal sinus surgery with unilateral or bilateral sinus opening. In case of 152 patients, corrective surgery of the nasal septum was additionally performed. The patients were divided into two groups (2D group and 3D group) comprising 173 patients each, who underwent paranasal sinus opening using 2D and 3D endoscopic visualization. Each group was divided into four subgroups: the first were patients after bilateral paranasal sinus surgery (PSS), the second were patients after bilateral endoscopic paranasal sinus surgery and nasal septal correction surgery (PSS+NS), the third were patients after unilateral paranasal sinus surgery (UPSS), and the fourth group was patients after unilateral endoscopic paranasal sinus surgery and nasal septum correction surgery (UPSS+NS). Methods: The surgery was carried out using a TipCam 3D endoscope from Storz (Germany), 18 mm in length, 4 mm in diameter, with 30° optics, with an integrated camera capable of transmitting 3D images, as well as classic 2D endoscopes, 16 mm in length, 4 mm in diameter and 30° optics, along with a video track and instrument set. Patients underwent unilateral or bilateral endoscopic surgery with opening of the maxillary sinuses, frontal sinuses, anterior and posterior ethmoid as well as corrective surgery of the nasal septum. Patients underwent unilateral or bilateral endoscopic surgery with opening of the maxillary sinuses, frontal sinuses, anterior and posterior ethmoid as well as corrective surgery of the nasal septum. Results: The length of surgery were as follows in the 2D group: 2D/PSS+NS group — 107 min. (±22); 2D/PSS group — 95 min (±24); 2D/UPSS+NS group — 68 min (±21); 2D/UPSS group — 53 min (±14); The length of surgery in the 3D group: 3D/PSS+NS group — 91 min. (±17); 3D/PSS group — 83 min (±20); 3D/UPSS+NS group — 69 min (±15); 2D/UPSS group — 49 min (±10); Among the complications were early and late postoperative bleeding, eyelid or orbital hematomas, and eyelid edema. There were 17 complications in the 2D group (9.82%), and 7 complications in the 3D group (4.05%). Conclusions: It was found that 3D endoscopic surgeries significantly reduced the length of surgery, especially in serious bilateral paranasal sinus surgeries. and influenced a decrease in perioperative complications. 3D endoscopic surgeries had no significant effect on the amount of blood loss and the length of the patient’s stay at the Clinic.
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Jane, John A., Joseph Han, Daniel M. Prevedello, Jay Jagannathan, Aaron S. Dumont, and Edward R. Laws. "Perspectives on endoscopic transsphenoidal surgery." Neurosurgical Focus 19, no. 6 (December 2005): 1–10. http://dx.doi.org/10.3171/foc.2005.19.6.3.
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Sellar tumors are most commonly approached through the transsphenoidal corridor, and tumor resection is most often performed using the operating microscope. More recently the endoscope has been introduced for use either as an adjunct to or in lieu of the microscope. Both the microscopic and endoscopic transsphenoidal approaches to sellar tumors allow safe and effective tumor resection. The authors describe their current endoscopic technique and elucidate the advantages and disadvantages of the pure endoscopic adenomectomy compared with the standard microscopic approach.
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Graham, Scott M., Tim A. Iseli, Lucy H. Karnell, John D. Clinger, Patrick W. Hitchon, and Jeremy D. W. Greenlee. "Endoscopic Approach for Pituitary Surgery Improves Rhinologic Outcomes." Annals of Otology, Rhinology & Laryngology 118, no. 9 (September 2009): 630–35. http://dx.doi.org/10.1177/000348940911800905.
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Objectives: We hypothesized that the endoscopic approach to pituitary surgery improves rhinology-specific quality of life and has satisfactory tumor outcomes compared with the open approach. Methods: Cases of pituitary surgery from the Department of Neurosurgery database included an inception cohort of all patients who had endoscopic procedures and consecutive patients who had open procedures between January 1998 and February 2008. The Sino-Nasal Outcome Test-22 was mailed. Results: Since January 1998, 71 endoscopic and 122 open pituitary surgeries had been performed. The mean follow-up was longer for open procedures (49.3 months) than for endoscopic procedures (18.8 months). Recurrence was more common after open surgery (28.4%) than after endoscopic surgery (18.2%; p = 0.219). The most common diagnosis was macroadenoma (77.1% of endoscopic procedures and 93.4% of open procedures). The mean hospital stay was shorter for endoscopic procedures (4.1 days) than for open procedures (6.0 days; p < 0.001). Of patients who presented with visual deterioration, 53.8% with endoscopic surgery and 46.7% with open surgery had improvement. Among patients with normal preoperative hormonal function, 27.5% of patients in the endoscopy group and 29.4% of patients in the open group required medication for more than 2 months after surgery. Complications occurred in 33.3% of endoscopic procedures and 43.4% of open procedures. Cerebrospinal fluid leaks were more common in the endoscopy group (p = 0.035), and diabetes insipidus lasting more than 30 days was more common in the open group (p = 0.017). The mean Sino-Nasal Outcome Test-22 score was lower for patients in the endoscopy group (20.4) than for those in the open group (23.2; p = 0.41). Patients in the endoscopy group had a significantly lower rhinology-specific mean score (6.5) than did patients in the open group (9.2; p = 0.03). Conclusions: The endoscopic approach to pituitary surgery offers tumor outcomes comparable to those of open surgery, with no greater incidence of complications and an improved rhinology-specific quality of life.
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Walther, Charles, Martin Jeremiasen, Pehr Rissler, Jan L. M. Johansson, Marie S. Larsson, and Bruno S. C. S. Walther. "A New Method for Endoscopic Sampling of Submucosal Tissue in the Gastrointestinal Tract." Surgical Innovation 23, no. 6 (July 9, 2016): 572–80. http://dx.doi.org/10.1177/1553350616646478.
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Background. Sampling of submucosal lesions in the gastrointestinal tract through a flexible endoscope is a well-recognized clinical problem. One technique often used is endoscopic ultrasound-guided fine-needle aspiration, but it does not provide solid tissue biopsies with preserved architecture for histopathological evaluation. To obtain solid tissue biopsies from submucosal lesions, we have constructed a new endoscopic biopsy tool and compared it in a crossover study with the standard double cupped forceps. Methods. Ten patients with endoscopically verified submucosal lesions were sampled. The endoscopist selected the position for the biopsies and used the instrument selected by randomization. After a biopsy was harvested, the endoscopist chose the next site for a biopsy and again used the instrument picked by randomization. A total of 6 biopsies, 3 with the forceps and 3 with the drill instrument, were collected in every patient. Results. The drill instrument resulted in larger total size biopsies (mm2; Mann-Whitney U test, P = .048) and larger submucosal part (%) of the biopsies (Mann-Whitney U test, P = .003) than the forceps. Two patients were observed because of chest pain and suspicion of bleeding in 24 hours. No therapeutic measures were necessary to be taken. Conclusion. The new drill instrument for flexible endoscopy can safely deliver submucosal tissue samples from submucosal lesions in the upper gastrointestinal tract.
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Ardila-Gatas, Jessica, and Wayne English. "Endoscopic management of early complications following bariatric surgery." Mini-invasive Surgery 6, no. 4 (2022): 21. http://dx.doi.org/10.20517/2574-1225.2021.133.
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Bariatric surgery procedures are increasing exponentially with the obesity epidemic. Early complications are defined as those that occur within the first 30 days after surgery. Some of the most common early complications are leaks, bleeding, stricture or stenosis and bezoar, all of which can be diagnosed and treated endoscopically. Upper endoscopy has been proven to be safe in the early postoperative period and different endoscopic modalities, like stenting, clipping, overstitch, among others, are part of the armamentarium the endoscopist should have available to address complications and potentially avoid the morbidity and mortality associated with re-operation.
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Strong, E. Bradley. "Endoscopic Dacryocystorhinostomy." Craniomaxillofacial Trauma & Reconstruction 6, no. 2 (June 2013): 67–74. http://dx.doi.org/10.1055/s-0032-1332212.
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External dacryocystorhinostomy was described in early 20th century. The introduction of nasal endoscopy and endoscopic sinus surgery in the 1980s paved the way for a transnasal endoscopic approach to lacrimal system. This article will review the indications and surgical techniques used for endoscopic dacryocystorhinostomy.
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Sufianov, A., R. Rustamov, Yu Yakimov, R. Sufianov, and Abdulrahman Alzahrani. "Repeated endoscopic third ventriculostomy (ETV). Role of advanced instruments for performing this minimally invasive surgery." Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery), no. 1 (January 1, 2020): 21–32. http://dx.doi.org/10.33920/med-01-2001-02.
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This series of studies presents the results of repeated endoscopic third ventriculostomy (ETV) in patients with occlusive hydrocephalus. 33 cases of repeated ETV were considered as a material for the study: 7 adult patients aged 18 years and older (19 % (3 men, 4 women)) and 26 children aged 0 to 17 years (81 % (15 boys, 11 girls)). The average period of clinical observation after the surgery was 42,3 ± 2,7 months. 21 patients (64 %) had the effect from the surgery, they became shunt-independent. 23 repeated endoscopic third ventriculostomy were performed using standard rigid endoscopes (Gaab, Lotta, Little Lotta Endoscopes), the other 10 surgeries were performed using miniature semi-rigid needle endoscope. There were no postoperative neurological, endocrine and infectious complications in the studied group.
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Klironomos, G., O. Khan, A. Mansouri, J. Ebinu, L. Gonen, I. Radovanovic, and G. Zadeh. "A cadaveric study in endoscopic 3D visualization of posterior fossa neurovascular complexes." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 42, S1 (May 2015): S42—S43. http://dx.doi.org/10.1017/cjn.2015.193.
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Background: The use of 3D endoscopy for posterior fossa surgery gradually adopted. In this study we compare the 3D to classic 2D endoscopy in evaluating neurovascular complexes in posterior fossa. Methods: Twenty retrosigmoid craniotomies, with a maximal diameter of 2cm were performed under neuronavigation on 10 fresh cadaveric heads. The posterior fossa dura matter was opened with a C-shaped incision and the base of the dural flap was placed over the sigmoid sinus. We used 3D and 2D endoscopes, with 0 and 45 degree angulations, connected to high definition camera lenses for optimal visualization of posterior fossa structures. Results: The superior, middle and inferior neurovascular complexes of the cerebellopontine angle were better visualized with 3D comparing to 2D endoscope. A detailed view of the porus trigeminous and structures associated with the tentorial incisura was also attained with 3D endoscopy. Conclusion: The high quality and resolution obtained by 3D endoscopy makes it a potentially valuable surgical and teaching tool in the armamentarium for endoscopic posterior fossa surgery. The stereoscopic view of the critical neurovascular structures of the posterior fossa, offered by 3D images, allows for a more detailed dissection in the difficult area of the cerebellopontine angle.
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Lewis, Adam I., Glenn L. Keiper, and Kerry R. Crone. "Endoscopic treatment of loculated hydrocephalus." Journal of Neurosurgery 82, no. 5 (May 1995): 780–85. http://dx.doi.org/10.3171/jns.1995.82.5.0780.
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✓ Loculated hydrocephalus remains a difficult neurosurgical problem and endoscopes designed to navigate through the ventricular system provide a new option for treatment. The authors review their experience, during the period March 1990 to June 1993, using a steerable fiberscope in 34 cases of loculated hydrocephalus to evaluate the efficacy of endoscopic cyst fenestration. The goals of treatment were to control hydrocephalus, simplify preexisting shunt systems, and reduce operative morbidity. Endoscopic cyst fenestrations reduced the shunt revision rate from 3.04 per year prior to endoscopy to 0.25 per year after the procedure, during a follow-up period ranging from 8 to 45 months, mean 26 months. However, eight patients (23.5%) required 14 repeat operations to control loculated hydrocephalus. After endoscopy, patients with multiloculated hydrocephalus had a nearly fivefold increased risk (relative risk 4.85) for shunt malfunction and more than a twofold increased risk (relative risk 2.43) for cyst recurrence versus patients with uniloculated hydrocephalus. Similarly, six (50%) of 12 patients shunted prior to endoscopy required a repeat endoscopic procedure (relative risk 5.56). Although repeat endoscopic procedures may be required to control hydrocephalus, endoscopic cyst fenestration avoided placement of a shunt in seven (33%) of 21 patients with uniloculated hydrocephalus. One patient, encountered early in the authors' experience, required a craniotomy for fenestration of multiple ventricular cysts. Endoscopic complications included cerebrospinal fluid leakage in one case and ventriculitis in another. The authors conclude that endoscopic treatment of loculated hydrocephalus is a safe, minimally invasive technique that should be considered as the initial treatment option.
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Sardesai, Ishan, D. R. Nayak, Aditi Ravindra, and Shama Shetty. "A comparative study of efficacy and outcomes of endoscopic versus conventional technique in septoturbinoplasty." International Journal of Otorhinolaryngology and Head and Neck Surgery 8, no. 8 (July 26, 2022): 657. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20221883.
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<p class="abstract"><strong>Background:</strong> Septal deviation is a very common clinical entity which often affects nasal aesthetics and functionality requiring surgical correction. With the advent of rigid endoscopy, newer techniques of endoscopic surgery have come into place that are replacing conventional methods. The aim of the study was to compare the two septoturbinoplasty procedures (endoscopic and conventional) using both objective and subjective data and thereby determine the advantages an endoscope provides during nasal septal surgery.</p><p class="abstract"><strong>Methods:</strong> It is a prospective comparative study of 56 patients out of which 28 patients underwent endoscopic septoturbinoplasty and the remaining 28 underwent conventional septoturbinoplasty. Outcomes measured were improvement of nasal symptoms following the surgery based on subjective questionnaire data collected, operation time and post-operative complications. </p><p class="abstract"><strong>Results:</strong> The mean NOSE questionnaire scores pre-operatively were 67.32±12.4 for the conventional group and 64.64±14.9 for the endoscopic group. The post-operative scores were 6.43±7.2 for the conventional group and 4.64±6.8 for the endoscopic group. Similarly, the operative time as well as the rate of post-operative complications were lesser in the endoscopic technique compared to the conventional technique.</p><p class="abstract"><strong>Conclusions:</strong> Both conventional and endoscopic techniques are effective in correcting the septal deviation as proved by significant subjective improvement in patient symptom scores post-surgery. The use of an endoscope, on the other hand, results in a shorter operation time and a lower complication rate after surgery.</p>
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Zhang, Zheng. "Research on endoscopic surgery based on SLAM." Applied and Computational Engineering 12, no. 1 (September 25, 2023): 58–64. http://dx.doi.org/10.54254/2755-2721/12/20230296.
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The Simultaneous Localization and Mapping (SLAM) method is widely used in the positioning and mapping of robots. In the medical field, SLAM is used in auxiliary medical robots and surgical robots. In endoscopic surgery, SLAM performs endoscopic positioning and scene graph construction for the surgical environment based on the information collected by the endoscope. For research on endoscopic SLAM, this article will first introduce the application of SLAM in endoscopic surgery in recent years. This paper summarizes the innovations and future work of relevant literature in recent years and identifies existing problems in SLAM in endoscopic surgery. Next, this article will introduce the combination of deep learning and SLAM in endoscopic surgery and list some specific applications. Finally, this paper will give a prospect for the future application of SLAM in endoscopic surgery. The research in this paper will be of great value to applying SLAM in endoscopic surgery and conducive to the development of future endoscopic SLAM.
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Basil, Gregory W., Vignessh Kumar, and Michael Y. Wang. "Optimizing Visualization in Endoscopic Spine Surgery." Operative Neurosurgery 21, Supplement_1 (June 15, 2021): S59—S66. http://dx.doi.org/10.1093/ons/opaa382.
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Abstract Given the inherent limitations of spinal endoscopic surgery, proper lighting and visualization are of tremendous importance. These limitations include a small field of view, significant potential for disorientation, and small working cannulas. While modern endoscopic surgery has evolved in spite of these shortcomings, further progress in improving and enhancing visualization must be made to improve the safety and efficacy of endoscopic surgery. However, in order to understand potential avenues for improvement, a strong basis in the physical principles behind modern endoscopic surgery is first required. Having established these principles, novel techniques for enhanced visualization can be considered. Most compelling are technologies that leverage the concepts of light transformation, tissue manipulation, and image processing. These broad categories of enhanced visualization are well established in other surgical subspecialties and include techniques such as optical chromoendoscopy, fluorescence imaging, and 3-dimensional endoscopy. These techniques have clear applications to spinal endoscopy and represent important avenues for future research.
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Conen, N., and T. Luhmann. "OVERVIEW OF PHOTOGRAMMETRIC MEASUREMENT TECHNIQUES IN MINIMALLY INVASIVE SURGERY USING ENDOSCOPES." ISPRS - International Archives of the Photogrammetry, Remote Sensing and Spatial Information Sciences XLII-2/W4 (May 10, 2017): 33–40. http://dx.doi.org/10.5194/isprs-archives-xlii-2-w4-33-2017.
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This contribution provides an overview of various photogrammetric measurement techniques in minimally invasive surgery and presents a self-developed prototypical trinocular endoscope for reliable surface measurements. Most of the presented techniques focus on applications regarding laparoscopy, which mean endoscopic operations in the abdominal or pelvic cavities. Since endoscopic operations are very demanding to the surgeon, various assistant systems have been developed. Imaging systems may use photogrammetric techniques in order to perform 3D measurements during operation. The intra-operatively acquired 3D data may be used for analysis, model registration, guidance or documentation. Passive and active techniques have been miniaturised, integrated into endoscopes and investigated by several research groups. The main advantages and disadvantages of several active and passive techniques adapted to laparoscopy are described in this contribution. Additionally, a self-developed trinocular endoscope is described and evaluated.
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Kawakubo, Hirofumi, Tai Omori, Rieko Nakamura, Tsunehiro Takahashi, Norihito Wada, Kazuo Koyanagi, Hiroya Takeuchi, Yoshiro Saikawa, and Yuko Kitagawa. "New endoscopic treatment for superficial carcinoma of borderline lesions between the cervical esophagus and hypopharynx." Journal of Clinical Oncology 31, no. 4_suppl (February 1, 2013): 107. http://dx.doi.org/10.1200/jco.2013.31.4_suppl.107.
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107 Background: Early diagnosis and early treatment are the best ways to improve cancer patient prognoses. We developed ELPS (endoscopic laryngo-pharyngeal surgery) as an endoscopic treatment for superficial pharyngeal carcinoma. ELPS is transoral endoscopic surgery for laryngeal cancer. After lifting the larynx using the laryngoscope, the endoscopist inserts endoscope and the operator inserts forceps and electric device transorally, and resects superficial phayngeal carcinoma. However, ELPS has not been applied for cervical esophagus carcinoma because of the narrow working space. We developed a hybrid endoscopic surgery (ESD+ELPS) for borderline lesions between the cervical esophagus and hypopharynx. The purpose of this study was to examine the usefulness and effectiveness of endoscopic treatment for superficial carcinoma of the hypopharynx and cervical esophagus. Methods: Hybrid endoscopic surgery (ESD and ELPS) was performed on 8 lesions, which involved both the hypopharynx and cervical esophagus. Results: Six of eight patients had esophageal cancer treatments in their past histories, two for ESD, two for esophagectomy and two for chemoradiation. All lesions were completely resected. The complications of this procedure were laryngeal edema for three patients, which required overnight intubation, and stenosis of cervical esophagus for two patients, which required endoscopic dilation more than 10 times. There were no long term complications in all patients. Conclusions: The results indicated the usefulness and effectiveness of hybrid endoscopic treatment (ELPS+ESD) for superficial carcinoma of borderline lesion between the cervical esophagus and hypopharynx.
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Xu, Xinghua, Xiaolei Chen, Fangye Li, Xuan Zheng, Qun Wang, Guochen Sun, Jun Zhang, and Bainan Xu. "Effectiveness of endoscopic surgery for supratentorial hypertensive intracerebral hemorrhage: a comparison with craniotomy." Journal of Neurosurgery 128, no. 2 (February 2018): 553–59. http://dx.doi.org/10.3171/2016.10.jns161589.
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OBJECTIVEThe goal of this study was to investigate the effectiveness and practicality of endoscopic surgery for treatment of supratentorial hypertensive intracerebral hemorrhage (HICH) compared with traditional craniotomy.METHODSThe authors retrospectively analyzed 151 consecutive patients who were operated on for treatment of supratentorial HICH between January 2009 and June 2014 in the Department of Neurosurgery at Chinese PLA General Hospital. Patients were separated into an endoscopy group (82 cases) and a craniotomy group (69 cases), depending on the surgery they received. The hematoma evacuation rate was calculated using 3D Slicer software to measure the hematoma volume. Comparisons of operative time, intraoperative blood loss, Glasgow Coma Scale score 1 week after surgery, hospitalization time, and modified Rankin Scale score 6 months after surgery were also made between these groups.RESULTSThere was no statistically significant difference in preoperative data between the endoscopy group and the craniotomy group (p > 0.05). The hematoma evacuation rate was 90.5% ± 6.5% in the endoscopy group and 82.3% ± 8.6% in the craniotomy group, which was statistically significant (p < 0.01). The operative time was 1.6 ± 0.7 hours in the endoscopy group and 5.2 ± 1.8 hours in the craniotomy group (p < 0.01). The intraoperative blood loss was 91.4 ± 93.1 ml in the endoscopy group and 605.6 ± 602.3 ml in the craniotomy group (p < 0.01). The 1-week postoperative Glasgow Coma Scale score was 11.5 ± 2.9 in the endoscopy group and 8.3 ± 3.8 in the craniotomy group (p < 0.01). The hospital stay was 11.6 ± 6.9 days in the endoscopy group and 13.2 ± 7.9 days in the craniotomy group (p < 0.05). The mean modified Rankin Scale score 6 months after surgery was 3.2 ± 1.5 in the endoscopy group and 4.1 ± 1.9 in the craniotomy group (p < 0.01). Patients had better recovery in the endoscopy group than in the craniotomy group. Data are expressed as the mean ± SD.CONCLUSIONSCompared with traditional craniotomy, endoscopic surgery was more effective, less invasive, and may have improved the prognoses of patients with supratentorial HICH. Endoscopic surgery is a promising method for treatment of supratentorial HICH. With the development of endoscope technology, endoscopic evacuation will become more widely used in the clinic. Prospective randomized controlled trials are needed.
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Sivananthan, Arun, Alexandros Kogkas, Ben Glover, Ara Darzi, George Mylonas, and Nisha Patel. "A novel gaze-controlled flexible robotized endoscope; preliminary trial and report." Surgical Endoscopy 35, no. 8 (May 24, 2021): 4890–99. http://dx.doi.org/10.1007/s00464-021-08556-1.
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Abstract Background Interventional endoluminal therapy is rapidly advancing as a minimally invasive surgical technique. The expanding remit of endoscopic therapy necessitates precision control. Eye tracking is an emerging technology which allows intuitive control of devices. This was a feasibility study to establish if a novel eye gaze-controlled endoscopic system could be used to intuitively control an endoscope. Methods An eye gaze-control system consisting of eye tracking glasses, specialist cameras and a joystick was used to control a robotically driven endoscope allowing steering, advancement, withdrawal and retroflexion. Eight experienced and eight non-endoscopists used both the eye gaze system and a conventional endoscope to identify ten targets in two simulated environments: a sphere and an upper gastrointestinal (UGI) model. Completion of tasks was timed. Subjective feedback was collected from each participant on task load (NASA Task Load Index) and acceptance of technology (Van der Laan scale). Results When using gaze-control endoscopy, non-endoscopists were significantly quicker when using gaze-control rather than conventional endoscopy (sphere task 3:54 ± 1:17 vs. 9:05 ± 5:40 min, p = 0.012, and UGI model task 1:59 ± 0:24 vs 3:45 ± 0:53 min, p < .001). Non-endoscopists reported significantly higher NASA-TLX workload total scores using conventional endoscopy versus gaze-control (80.6 ± 11.3 vs 22.5 ± 13.8, p < .001). Endoscopists reported significantly higher total NASA-TLX workload scores using gaze control versus conventional endoscopy (54.2 ± 16 vs 26.9 ± 15.3, p = 0.012). All subjects reported that the gaze-control had positive ‘usefulness’ and ‘satisfaction’ score of 0.56 ± 0.83 and 1.43 ± 0.51 respectively. Conclusions The novel eye gaze-control system was significantly quicker to use and subjectively lower in workload when used by non-endoscopists. Further work is needed to see if this would translate into a shallower learning curve to proficiency versus conventional endoscopy. The eye gaze-control system appears feasible as an intuitive endoscope control system. Hybrid gaze and hand control may prove a beneficial technology to evolving endoscopic platforms.
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Tanaka, Tatsuya, Hirofumi Goto, Nobuaki Momozaki, and Eiichiro Honda. "Endoscopic hematoma evacuation for acute subdural hematoma with improvement of the visibility of the subdural space and postoperative management using an intracranial pressure sensor." Surgical Neurology International 14 (January 6, 2023): 1. http://dx.doi.org/10.25259/sni_1084_2022.
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Background: The first choice to treat acute subdural hematoma (ASDH) is large craniotomy under general anesthesia. However, increasing age or the comorbid burden of patients may render invasive treatment strategy inappropriate. These medically frail patients with ASDH may benefit from a combination of small craniotomy and endoscopic hematoma removal, which is less invasive. We proposed covering with protective sheets to prevent brain injury due to contact with the endoscope and suction cannula and improve visualization of the subdural space. Moreover, we placed an intracranial pressure (ICP) sensor after endoscopic hematoma removal. In this article, we attempted to clarify the use of small craniotomy evacuation with endoscopy for ASDH. Methods: Between January 2015 and December 2019, nine patients with ASDH underwent hematoma evacuation with endoscopy at our hospital. ASDH was removed using a suction tube with the aid of a rigid endoscope through the small craniotomy (5–6 cm). Improvement of the clinical symptoms and procedure-related complications was evaluated. Results: No procedure-related hemorrhagic complications were observed. The outcomes of our endoscopic surgery were satisfactory without complications or rebleeding. The outcomes were not inferior to those of other reported endoscopic surgeries. Conclusion: The results suggest that small craniotomy evacuation with endoscopy and postoperative management using an ICP sensor is a safe, effective, and minimally invasive treatment approach for ASDH in appropriately selected cases.
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van Lindert, Erik J., and J. André Grotenhuis. "New Endoscope Shaft for Endoscopic Transsphenoidal Pituitary Surgery." Operative Neurosurgery 57, suppl_1 (July 1, 2005): 203–6. http://dx.doi.org/10.1227/01.neu.0000163681.28487.2f.
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Abstract OBJECTIVE: To describe a new endoscope shaft developed for suction-aspiration during endoscopic transsphenoidal pituitary surgery. METHODS: A custom-made shaft for a Wolf endoscope (Richard Wolf GmbH, Knittlingen, Germany) was developed with a height of 10 mm and a width of 5 mm, allowing an additional working channel for the endoscope for flexible suction tubes with a diameter of up to 10-French. RESULTS: The new shaft was used in 30 consecutive endoscopic transsphenoidal procedures for pituitary adenomas. It allowed true bimanual manipulation without having to fixate the endoscope. Tumor removal was facilitated, technical problems were not encountered, and operation time was reduced. There were no instrumentation-related complications. CONCLUSION: The new shaft improves the ergonomics of endoscopic transsphenoidal pituitary surgery in cases in which the endoscope is handheld.
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Kawamata, Takakazu, Hiroshi Iseki, Takao Shibasaki, and Tomokatsu Hori. "Endoscopic Augmented Reality Navigation System for Endonasal Transsphenoidal Surgery to Treat Pituitary Tumors: Technical Note." Neurosurgery 50, no. 6 (June 1, 2002): 1393–97. http://dx.doi.org/10.1097/00006123-200206000-00038.
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Abstract OBJECTIVE Endoscopes have been commonly used in transsphenoidal surgery to treat pituitary tumors, to compensate for the narrow surgical field. Although many navigation systems have been introduced for neurosurgical procedures, there have been few reports of navigation systems for endoscopic operations. This report presents our recently developed, endoscopic, augmented reality (AR) navigation system. METHODS The technology is based on the principles of AR environment technology. The system consisted of a rigid endoscope with light-emitting diodes, an optical tracking system, and a controller. The operation of the optical tracking system was based on two sets of infrared light-emitting diodes, which measured the position and orientation of the endoscope relative to the patient's head. We used the system during endonasal transsphenoidal operations to treat pituitary tumors in 12 recent cases. RESULTS Anatomic, “real,” three-dimensional, virtual images of the tumor and nearby anatomic structures (including the internal carotid arteries, sphenoid sinuses, and optic nerves) were superimposed on real- time endoscopic live images. The system also indicated the positions and directions of the endoscope and the endoscopic beam in three-dimensional magnetic resonance imaging or computed tomographic planes. Furthermore, the colors of the wire-frame images of the tumor changed according to the distance between the tip of the endoscope and the tumor. These features were superior to those of conventional navigation systems, which are available only for operating microscopes. CONCLUSION The endoscopic AR navigation system allows surgeons to perform accurate, safe, endoscope-assisted operations to treat pituitary tumors; it is particularly useful for reoperations, in which midline landmarks may be absent. We consider the AR navigation system to be a promising tool for safe, minimally invasive, endonasal, transsphenoidal surgery to treat pituitary tumors.