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Review
. 2022 Jun 14;14(12):2931.
doi: 10.3390/cancers14122931.

Specialised Surgical Instruments for Endoscopic and Endoscope-Assisted Neurosurgery: A Systematic Review of Safety, Efficacy and Usability

Holly Aylmore  1 , Emmanouil Dimitrakakis  2 , Joshua Carmichael  3 , Danyal Z Khan  1   4 , Danail Stoyanov  2 , Neil L Dorward  4 , Hani J Marcus  1   2   4
Affiliations
Review

Specialised Surgical Instruments for Endoscopic and Endoscope-Assisted Neurosurgery: A Systematic Review of Safety, Efficacy and Usability

Holly Aylmore et al. Cancers (Basel). .

Abstract

While there have been great strides in endoscopic and endoscope-assisted neurosurgical approaches, particularly in the treatment of deep-sited brain and skull base tumours, the greatest technical barrier to their adoption has been the availability of suitable surgical instruments. This systematic review seeks to identify specialised instruments for these approaches and evaluate their safety, efficacy and usability. Conducted in accordance with the PRISMA guidelines, Medline, Embase, CENTRAL, SCOPUS and Web of Science were searched. Original research studies that reported the use of specialised mechanical instruments that manipulate tissue in human patients, cadavers or surgical models were included. The results identified 50 specialised instruments over 62 studies. Objective measures of safety were reported in 32 out of 62 studies, and 20 reported objective measures of efficacy. Instruments were broadly safe and effective with one instrument malfunction noted. Measures of usability were reported in 15 studies, with seven reporting on ergonomics and eight on the instruments learning curve. Instruments with reports on usability were generally considered to be ergonomic, though learning curve was often considered a disadvantage. Comparisons to standard instruments were made in eight studies and were generally favourable. While there are many specialised instruments for endoscopic and endoscope-assisted neurosurgery available, the evidence for their safety, efficacy and usability is limited with non-standardised reporting and few comparative studies to standard instruments. Future innovation should be tailored to unmet clinical needs, and evaluation guided by structured development processes.

Keywords: cancer; endoscopy; keyhole surgery; surgical instruments.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
PRISMA flow diagram of the inclusion and exclusion of studies.
Figure 2
Figure 2
Year of publication of included studies.
Figure 3
Figure 3
Number of novel instruments identified by neurosurgical speciality.
Figure 4
Figure 4
Number of novel instruments identified by function of instrument.
See this image and copyright information in PMC

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References

    1. Carroll L. Through the Looking-Glass and What Alice Found There. Macmillan; London, UK: 1871.
    1. Hughes-Hallett A., Mayer E., Marcus H., Cundy T., Pratt P., Parston G., Vale J., Darzi A. Quantifying Innovation in Surgery. Ann. Surg. 2014;260:205–211. doi: 10.1097/SLA.0000000000000662. - DOI - PubMed
    1. Cappabianca P., Cavallo L.M., Colao A., De Divitiis E. Surgical complications associated with the endoscopic endonasal transsphenoidal approach for pituitary adenomas. J. Neurosurg. 2002;97:293–298. doi: 10.3171/jns.2002.97.2.0293. - DOI - PubMed
    1. Castelnuovo P., Lepera D., Turri-Zanoni M., Battaglia P., Villaret A.B., Bignami M., Nicolai P., Dallan I. Quality of life following endoscopic endonasal resection of anterior skull base cancers: Clinical article. J. Neurosurg. JNS. 2013;119:1401–1409. doi: 10.3171/2013.8.JNS13296. - DOI - PubMed
    1. Marcus H.J., Cundy T.P., Hughes-Hallett A., Yang G.Z., Darzi A., Nandi D. Endoscopic and keyhole endoscope-assisted neurosurgical approaches: A qualitative survey on technical challenges and technological solutions. Br. J. Neurosurg. 2014;28:606–610. doi: 10.3109/02688697.2014.887654. - DOI - PMC - PubMed

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