gms | German Medical Science

We can distinguish an early and an advanced period of neuroendoscopy depending on the technical development of the endoscopes. The early period comprised the first two decades of the 20^th century. Nitze type cystoscopes were tested for neurosurgical application at several American universities. Among others Kanavel with the urologist Lespinasse fulgurated the choroid plexus in 1910 and Mixter 1923 performed the first ETV with the same method as is performed today. However after few operations this endoscopic method due to mechanical and optical limitations of this first generation of endoscopes was given up.

The advanced period of neuroendoscopy with broad field of applications became possible by means of the technical improvements made in the 50^s by the British physicist Harold Horaz Hopkins (1918-1994). He had the idea for flexible endoscopes and made successful basic research for light transmission through flexible glass fibers by means of total reflection. However Hopkins name is mainly associated with the improvement of optical quality of rigid endoscopes. He replaced the relay lenses with long interspaces of air by rod lenses with higher refraction which reversed in the shaft the proportion of air and glass and together with better isolation improved the light transmission by a factor of 80 in relation to the standard Nitze endoscopes.

In the 60^s and 70^s neuroendoscopic procedures were rediscovered by Griffith, Fukushima and Guiot. In the 80^s ETV were performed with the Hopkins system by Kelly and Manwaring in US, Sainte Rose in Paris and Jones and Teo in Australia. In the 90^s systematic application in the ventricles and subarachnoidal space with anatomic basic research within the scope of minimally invasive neurosurgery with common ideas and common education courses was established by Perneczky, Gaab, Bauer/Hellwig at three universities in Germany together with Grotenhuis in Netherland and by Caemaert in Belgium. Since the 1^st decade of 20^th century many new indications for neuroendoscopic treatment were elaborated such as transsphenoidal pituitary, skull base, decompression of periferal nerves and spinal surgery. Most of these techniques became meanwhile standard procedures in neurosurgery.