Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Mar 26:10:46.
doi: 10.25259/SNI-45-2019. eCollection 2019.

QEVO® - A new digital endoscopic microinspection tool - A cadaveric study and first clinical experiences (case series)

Karl-Michael Schebesch  1 , Alexander Brawanski  1 , Ernst R Tamm  2 , Thomas S Kühnel  3 , Julius Höhne  1
Affiliations

QEVO® - A new digital endoscopic microinspection tool - A cadaveric study and first clinical experiences (case series)

Karl-Michael Schebesch et al. Surg Neurol Int. .

Abstract

Background: The use of endoscopes in neurosurgery is well established, but the integration of a full high definition signaling, 45° angled endoscopic tool into a digital surgical microscope, is new. We report our first experiences in a cadaveric study and a clinical case series using the new microinspection tool QEVO® that serves as a plug-in feature for the recently launched KINEVO 900 digital visualization platform (CARL ZEISS MEDITEC, Oberkochen, Germany). For illustration purposes, we offer video footage.

Methods: The handling, workflow, and visualization patterns of the QEVO® microinspection tool were critically evaluated in cadaver specimens by simulating four standardized neurosurgical approaches: (1) pterional, (2) retrosigmoidal, (3) transsphenoidal, (4) and transcallosal. Similarly, we evaluated the QEVO® tool in corresponding clinical cases of (1) aneurysm clipping, (2) removal of cerebellar cavernoma, (3) and pituitary adenomectomy.

Results: In both the cadaveric study and clinical case series, the QEVO® tool was found to be beneficial in terms of high-quality visualization of fine structures and for displaying hidden anatomical details ("looking around the corner"). The handling was good, and the workflow was easy. However, the use of this tool was restricted by the lack of an external fixation and a working channel, the shortness of the tool, and the impossibility to switch to a 0° or 30° optic.

Conclusion: Despite some restrictions, the QEVO® microinspection tool is an innovative, handheld, endoscopic tool that allows excellent additional visualization of the surgical field. In our opinion, this tool effectively enhances the modern neurosurgical armamentarium.

Keywords: Endoscopy; KINEVO; QEVO; microinspection tool; surgical microscope.

PubMed Disclaimer

Conflict of interest statement

K.-M.S, A.B. and J.H. have received honoraria and travel funds from Carl Zeiss Meditec, Germany.

Figures

Figure 1:
Figure 1:
The KINEVO 900.
Figure 2:
Figure 2:
The microinspection tool QEVO®.
Figure 3:
Figure 3:
Setup in the dissection room: with ZEISS KINEVO 900, 4K three-dimensional (3D) monitor, and TRENION 3D high definition.
See this image and copyright information in PMC

References

    1. Apuzzo ML, Heifetz MD, Weiss MH, Kurze T. Neurosurgical endoscopy using the side-viewing telescope. J Neurosurg. 1977;46:398–400. - PubMed
    1. Barone DG, Lawrie TA, Hart MG. Image guided surgery for the resection of brain tumours. Cochrane Database Syst Rev. 2014;1:CD009685. - PMC - PubMed
    1. Cohen AR, Perneczky A, Rodziewicz GS, Gingold SI. Endoscope-assisted craniotomy: Approach to the rostral brain stem. Neurosurgery. 1995;36:1128–9. - PubMed
    1. Demerdash A, Rocque BG, Johnston J, Rozzelle CJ, Yalcin B, Oskouian R, et al. Endoscopic third ventriculostomy: A historical review. Br J Neurosurg. 2017;31:28–32. - PMC - PubMed
    1. Limbrick DD, Jr, Baird LC, Klimo P, Jr, Riva-Cambrin J, Flannery AM, et al. Pediatric Hydrocephalus Systematic Review and Evidence-Based Guidelines Task Force. Pediatric hydrocephalus: Systematic literature review and evidence-based guidelines. Part 4: Cerebrospinal fluid shunt or endoscopic third ventriculostomy for the treatment of hydrocephalus in children. J Neurosurg Pediatr. 2014 - PubMed

LinkOut - more resources