[Clinical application and future prospect of neuroendoscopic surgery]

Abstract

The clinical application and future prospect of neuroendoscopic surgery are described. In the historical trend, it is emphasized that the neuroendoscopic surgery has become one of the major or leading procedures in "minimally-invasive approaches" to the intracranial lesions. The presently-available instrument include procedures using an endoscope of three different types: rigid-rod, steerable/flexible-fiber-rod and semi-rigid-rod. To use a rigid-rod or fiber-rod scope, it is available to apply forceps, laser, a microballoon and other fine instruments. The indication for neuroendoscopic surgery has been expanded to almost all neurosurgical procedures, as "endoscope-assisted" procedures are applied more to micro neurosurgical procedures (endoscope-assisted microsurgery). The realistic indication for "pure neuroendoscopic surgery" includes reconstruction of cerebrospinal fluid (CSF) pathway such as third ventriculostomy, septostomy, foramen reconstruction, fenestration of septation; removal or biopsy of tumor/cystic lesion, mainly in the intraventricular regions; and removal of hematoma involving the cerebral parenchyma (intracerebral hematoma), ventricles/(intraventricular hematoma) or subdural space (subdural hematoma). The intraparenchymal or deep-seated intracisternal lesions can be the realistic indication for "pure neuroendoscopic surgery" when the instrument are further developed in future. Neuroendoscopic surgery will play a promising and major role in the "minimally-invasive neurological procedure" in the 21st century.