gms | German Medical Science

Objective: Neuroendoscopy is increasingly used as an adjunctive tool in intracranial aneurysm surgery. The aim of the present anatomical study was to assess the versatility of a prototype continuously variable-view rigid endoscope in visualising the anterior cerebral artery complex.

Methods: In five formaldehyde fixed, arterially injected specimens a standard frontolateral approach was performed on both sides. After meticulous microsurgical dissection of the appraoch, the prototype of a multivariable rigid endoscope (EndoCAMeleon, Karl Storz, Tuttlingen, Germany) was inserted for inspecting the anterior cerebral artery complex, utilising and testing the facilities of the device.

Results: The continuously variable viewing mechanism enables the surgeon to adjust the field of view continuously and to optimise the visualisation of the neurovascular structures. Due to the rigid tip combined with the continuously variable viewing mechanism, the necessity to move the endoscope within the surgical field was minimal. The field of view changes but the tip itself hardly moves. The prototype was able to enhance both the visibility of the anterior cerebral artery complex as well as the accessibility of the A1 and A2 arterial walls to a range of approximately 270°.

Conclusions: The endoscope with continuous variable viewing mechanism enhances the visibility of the anterior cerebral artery complex and facilitates endoscope-assisted inspection, planning of clip application and control of clip position. The device has the potential to become a most useful, safe and easy to use adjuvant tool in aneurysm surgery.