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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

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New perspectives for endoscopic neurosurgery – an anatomic study with a rigid, multidirectional steerable videoendoscope

Meeting Abstract

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  • Florian H. Ebner - Klinik für Neurochirurgie, Eberhard-Karls-Universität Tübingen, Germany
  • Martin U. Schuhmann - Klinik für Neurochirurgie, Eberhard-Karls-Universität Tübingen, Germany
  • Jakob S. Marquardt - Klinik für Neurochirurgie, Eberhard-Karls-Universität Tübingen, Germany
  • Bernhard Hirt - Institut für Klinische Anatomie, Eberhard-Karls-Universität Tübingen, Germany
  • Juergen Honegger - Klinik für Neurochirurgie, Eberhard-Karls-Universität Tübingen, Germany
  • Stephan Herlan - Klinik für Neurochirurgie, Eberhard-Karls-Universität Tübingen, Germany
  • Marcos Tatagiba - Klinik für Neurochirurgie, Eberhard-Karls-Universität Tübingen, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1645

doi: 10.3205/10dgnc118, urn:nbn:de:0183-10dgnc1182

Published: September 16, 2010

© 2010 Ebner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: To assess field of view, usability and applicability of a prototype of a rigid, multidirectional steerable videoendoscope (EndActive, Karl Storz, Tuttlingen) in various intracranial regions relevant to neurosurgical practice.

Methods: In four cadaveric specimens frontolateral, pterional, transnasal (to sella and clivus), interhemispheric (transcallosal and retrocallosal) and retrosigmoid approaches as well as precoronal burr-holes for ventriculoscopy were performed. Anatomical target structures were defined in each region. We assessed field of view as well as optical and ergonomic features of the prototype. It is a 4 mm diameter rigid video(endo)scope with an integral image sensor comprising an embedded light source. The viewing direction in a range of 160° can either be controlled by the computer keyboard or a four-way joystick, mounted to the handle section of the endoscope. The endoscopic imaging system allows the operator to simultaneously see both a 160° degree wide-angle view of the site and an inset of a specific region of interest. The system provides an image levelling function based on an inclination sensor.

Results: The surgeon can hold the rigid, multidirectional steerable videoendoscope like a microsurgical instrument in one hand and control movements precisely due to reduced weight and ergonomic shape of the device. The multiplanar variable-view rigid endoscope proofed to be extremely useful for following anatomical structures (cranial nerves I-XII). The device is most effective in narrow working spaces where movements jeopardize the delicate surrounding structures.

Conclusions: From an ergonomic point of view, the EndActive is an important improvement in neuroendoscopy. The multiplanar variable viewing mechanism in this small and elegant tool offers formidable advantages in terms of safety and comfort.