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. 2013 Jul;8(3):125-31.
doi: 10.4103/1793-5482.121681.

Optimal invasive key-hole neurosurgery with a miniaturized 3D chip on the tip: Microendoscopic device

Patra Charalampaki  1 , Alhadi Igressa  1 , Mehran Mahvash  1 , Ioannis Pechlivanis  1 , Bernhard Schick  2
Affiliations

Optimal invasive key-hole neurosurgery with a miniaturized 3D chip on the tip: Microendoscopic device

Patra Charalampaki et al. Asian J Neurosurg. 2013 Jul.

Abstract

Objective: The goal of the performed study was to evaluate the possibility of a three-dimensional endoscope to become a combined microscope-endoscope device in one. We analyzed the ergonomy of the device, the implementation into the surgical workflow, the image quality, and the future perspectives such devices could have for the next generation of neurosurgeons.

Materials and methods: Within 6 months, 22 patients (10 male, 12 female, 20-65 age) underwent surgery in neuroaxis using the new 3D-microendoscope (ME). The new 3D-ME has (a) the ability to visualize the surgical field from out- to inside with all advantages offered by a microscope, and in the same moment, (b) its design is like a small diameter endoscope that allows stereoscopic views extracorporal, intracorporal, and panoramic "para-side" of the lesion.

Results: In general, transcranial 3D-"microendoscopy" was performed in all patients with high-resolution 3D quality. No severe complications were observed intra- or postoperatively. With the addition of depth perception, the anatomic structures were well seen and observed.

Conclusion: The 3D-microendoscopy is a very promising surgical concept associated with new technological developments. The surgeon is able to switch to a modern visualization instrument reaching the most optimal surgical approach without compromising safety, effectiveness, and visual information.

Keywords: Endoscopy; microendoscopy; skull base surgery; three dimensionality.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
(a) Set-up of the 3D microendoscope in front of the surgical field using it as a microscope, and (b) in the depth of the surgical corridor as an endoscope in the same time, and (c) as a miniaturized combined micro-, and endoscope tool in one at the same procedure. (d) At the end of the surgery controlling the field with the microscope
Figure 2
Figure 2
Olfactory groove meningioma: Preoperative MRI scans (a) coronar, and (b) sagittal slices. Postoperative MRI scans showed no tumor residual, (c) coronar, and (d) sagittal slices
Figure 3
Figure 3
(a) Intraoperative view of the suprasellar cistern with tumor, and (b) without tumor
Figure 4
Figure 4
Left-sided epidermoid: Preoperative MRI scans, (a, b) axial slices. (c, d) Postoperative MRI scans showed no tumor residual
Figure 5
Figure 5
(a) Intraoperative microendoscopic view with epidermoid mass. (b) After opening the suprasellar cistern, carotic - basilar artery complex and optic nerve is visible
Figure 6
Figure 6
Left-sided foramen magnum meningioma: (a-c) Preoperative MRI scans showed the tumor left sided on the craniocervical junction. (d-f) Postoperative MRI scans showed no tumor residual
Figure 7
Figure 7
(a) Intraoperative view of the tumor on cerebellomedular angle. (b) After tumor removal, vertebral artery, XI, XII, and C1 nerve roots were visible
See this image and copyright information in PMC

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