gms | German Medical Science

65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

Comparison of 2D HD and 3D endoscopy during surgery for perisellar pathologies

Meeting Abstract

  • Rüdiger Gerlach - Department of Neurosurgery, HELIOS Klinikum Erfurt
  • Christoph Jacobi - Department of Neurosurgery, HELIOS Klinikum Erfurt
  • Christian Schönfelder - Department of Neurosurgery, HELIOS Klinikum Erfurt
  • Almuth Meyer - Department of Endocrinology, HELIOS Klinikum Erfurt
  • Elisabeth Lamster - Department of Endocrinology, HELIOS Klinikum Erfurt
  • Geralf Kellner - Department of ENT Surgery, HELIOS Klinikum Erfurt

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocDI.08.07

doi: 10.3205/14dgnc158, urn:nbn:de:0183-14dgnc1584

Published: May 13, 2014

© 2014 Gerlach et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Although endoscopic surgical procedures have many advantages over microsurgical procedures the lack of stereoscopic vision is a major disadvantage. To overcome this problem 3 D endoscopic systems have been introduced recently and are used in endonasal endoscopic transsphenoidal surgery (EETS). The objective of this study was to compare treatment results after EETS between a three dimensional endoscopic system and a 2D high definition (HD) system with respect to residual tumor, periprocedural complications or new postoperative endocrinological deficits.

Method: Between December 2008 and March 2013 112 patients (65 males, 58%) underwent EETS to treat (para)sellar pathologies (86 adenomas, 5 pituitary abcesses, 3 chordoma, 3 meningioma, and other pathologies n=15). In 65 patients the 2D HD System from Storz (Karl Storz, Germany) and in 47 the 3D VSii system (VisionSense®, USA) was used. Prospective collected data were entered into a SPSS database including pre- and postoperative neuroradiological, endocrinological and ophthalmological status.

Results: Sex, age, pathology and tumour volume did not statistically differ between both groups. In the 2D group 6 patients (9.2%) had perioperative complications (3 hematoma, 2 CSF fistula, [1 patient developed meningitis], 1 pulmonary embolus. In the group of patients treated with the 3D System 5 patients (10,6%) had complications (1 patient with new diabetes insipidus, 3 CSF fistula with reoperation in 1 patient). 3 months MRI depicted residual tumour in 15 (23%) and in 10 (21%) patients and in 11 (17%) and 2 (4%) patients differentiation of residual tumour and postoperative changes was uncertain in the 2D and 3D group, respectively. 9 and 10 patients developed a new endocrine deficit in any of the hormone axis during the postoperative course in the 2D and 3D group, respectively.

Conclusions: In this series the rate of residual tumour and perioperative complications after EETS was similar using a 2D HD system or the VSii 3D system. 3D impression during surgery, good detail accuracy and colour fidelity is provided by the VSii 3D system.