Artikel
Endoscope-controlled microneurosurgery (ECM): eccentric technique or future of neurosurgery?
Endoskop-kontrollierte Mikroneurochirurgie (ECM): Exzentrische Technik oder Zukunft der Neurochirurgie?
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Autoren
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N. Hopf
- Neurochirurgische Klinik, Katharinenhospital, Klinikum Stuttgart
| Veröffentlicht: | 8. Mai 2006 |
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Gliederung
Text
Objective: Endoscopes enable high visual resolution and brilliant illumination. Therefore, endoscopes are well suited for minimally invasive neurosurgical procedures with limited craniotomies. However, terminology, indication, and distinguished technique for endoscopic procedures are still not commonly accepted. In this study, we analyse the distinct technique of endoscope-controlled microneurosurgery (ECM) in a variety of neurosurgical procedures.
Methods: ECM is characterized by performing all surgical manipulations beside the endoscope with the endoscope as the only optical tool. This technique was used in 96 surgical procedures, including tumours (pituitary adenomas, acoustic neuromas, epidermoids, meningiomas, craniopharyngioma), vascular malformations (aneurysms, cavernomas), cysts (arachnoid cysts, colloid cysts), and trigeminal neuralgia.
Results: ECM was used in 28 of 96 procedures as the primary technique. In 68 of 96 procedures, ECM was used only for a limited part of surgery in combination with microsurgical technique. ECM was found to be of advantage in all procedures used, due to additional anatomical information. Limitations were fogging of the lens and insufficient fixation.
Conclusions: Presently, ECM is an eccentric technique but has the potential to become the future. This requires a convenient, ergonomic, and integrative system to overcome present limitations, such as fogging of the lens and inadequate fixation. In addition, such a system has to provide at least the same quality and features as operating microscopes and the specific advantages of endoscopes.
