Article
Progress of neuroendoscopy in the last 80 years
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Authors
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Florian H. Ebner
- Department of Neurosurgery, Eberhard-Karls-University, Tübingen, Deutschland
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Marcos Tatagiba
- Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
| Published: | June 9, 2017 |
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Outline
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Objective: To report about the technological development and the pioneers who sustainably influenced neuroendoscopy over the last 80 years.
Methods: Literature review with the key words “neuroendoscopy”, “ventricles”, “endocopic neurosurgery”
Results: The roots of endoscopy are in internal medicine, general surgery and urology. Therefore it was not by chance that Walter Dandy received a thin endoscope from the “father of cystoscopy” Howard Kelly for coagulation of the choroid plexus in hydrocephalus patients. Dandy concluded rather disappointed that “the instruments, in their relatively primitive construction, were not quite adaptable” (WE Dandy, 1922). However, he recognized the potential of the technique and supported technological improvements. In 1923 Tracy Putnam performed the first endoscopic ventriculocisternostomy. Despite this success the devices were so limited that the method of ventriculo-peritoneal shunting completely put intraventricular endoscopy out to grass. Interestingly it was during exactly that time that fundamental technological advancements have been achieved. Hopkins developed, a lense with magnification, Karl Storz the cold light source and later Smith and Boyle the CCD-chip. In 1978 thanks to the the improved devices Vries re-introduced the endoscopic ventriculocisternostomy as an attractive and successful alternative treatment of hydrocephalus patients. ENT surgeons recognized the potential of the endoscope. Wolfgang Draf and Heinz Stammberger are two pioneers of the functional endoscopic sinus surgery (FESS). The FESS is the base of a further field of endoscopy, the interdisciplinary endoscopic transnasal skull base surgery. Axel Perneczky is considered the father of intracranial endoscopic microneurosurgery. He brought the endoscope-assisted and endoscope-controlled techniques to perfection. Meanwhile, endoscopy is applied to several fields in neurosurgery from pure endoscopic intraventricular procedures to skull base surgery, vascular, cerebello-pontine angle and peripheral nerve surgery.
Conclusion: Neuroendoscopy developed over the last 80 years due to an interaction between the pioneers in medical technology and surgery. Future progress depends on an intense cooperation between technology and medicine.
