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. 2014 Oct;28(5):606-10.
doi: 10.3109/02688697.2014.887654. Epub 2014 Feb 17.

Endoscopic and keyhole endoscope-assisted neurosurgical approaches: a qualitative survey on technical challenges and technological solutions

Hani J Marcus  1 , Thomas P Cundy, Archie Hughes-Hallett, Guang-Zhong Yang, Ara Darzi, Dipankar Nandi
Affiliations

Endoscopic and keyhole endoscope-assisted neurosurgical approaches: a qualitative survey on technical challenges and technological solutions

Hani J Marcus et al. Br J Neurosurg. 2014 Oct.

Abstract

Introduction: The literature reflects a resurgence of interest in endoscopic and keyhole endoscope-assisted neurosurgical approaches as alternatives to conventional microsurgical approaches in carefully selected cases. The aim of this study was to assess the technical challenges of neuroendoscopy, and the scope for technological innovations to overcome these barriers.

Materials and methods: All full members of the Society of British Neurosurgeons (SBNS) were electronically invited to participate in an online survey. The open-ended structured survey asked three questions; firstly, whether the surgeon presently utilises or has experience with endoscopic or endoscope-assisted approaches; secondly, what they consider to be the major technical barriers to adopting such approaches; and thirdly, what technological advances they foresee improving safety and efficacy in the field. Responses were subjected to a qualitative research method of multi-rater emergent theme analysis.

Results: Three clear themes emerged: 1) surgical approach and better integration with image-guidance systems (20%), 2) intra-operative visualisation and improvements in neuroendoscopy (49%), and 3) surgical manipulation and improvements in instruments (74%).

Discussion: The analysis of responses to our open-ended survey revealed that although opinion was varied three major themes could be identified. Emerging technological advances such as augmented reality, high-definition stereo-endoscopy, and robotic joint-wristed instruments may help overcome the technical difficulties associated with neuroendoscopic approaches.

Conclusions: Results of this qualitative survey provide consensus amongst the technology end-user community such that unambiguous goals and priorities may be defined. Systems integrating these advances could improve the safety and efficacy of endoscopic and endoscope-assisted neurosurgical approaches.

Keywords: endoscopy; minimally invasive surgical procedures; neuroendoscopy; questionnaires.

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Figures

Figure 1
Figure 1
Qualitative analysis methodology.
Figure 2
Figure 2
Themes and subthemes, in order of frequency that they were mentioned. Note that each respondent could mention several sub-themes, so totals do not tally to 100%. IGS = Image Guidance System; 3D = 3-Dimensional; HD = High Definition
See this image and copyright information in PMC

References

    1. Perneczky A, Reisch R. Keyhole approaches in neurosurgery. Volume 1: Concept and surgical technique. 1 ed Springer; 2008.
    1. Reisch R, Stadie A, Kockro RA, Hopf N. The Keyhole Concept in Neurosurgery. World Neurosurg. 2012 Feb 10; - PubMed
    1. Prevedello DM, Doglietto F, Jane JA, Jr., Jagannathan J, Han J, Laws ER., Jr. History of endoscopic skull base surgery: its evolution and current reality. J Neurosurg. 2007 Jul;107(1):206–213. - PubMed
    1. Pernar LI, Ashley SW, Smink DS, Zinner MJ, Peyre SE. Master surgeons’ operative teaching philosophies: a qualitative analysis of parallels to learning theory. J Surg Educ. 2012 Jul-Aug;69(4):493–498. - PubMed
    1. Hsu W, Li KW, Bookland M, Jallo GI. Keyhole to the brain: Walter Dandy and neuroendoscopy. J Neurosurg Pediatr. 2009 May;3(5):439–442. - PubMed

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