A multifunctional, modified rigid neuroendoscopic system: clinical experience with 83 procedures

Abstract

The authors combined a monopolar electrode and a suction/irrigation channel with a 0 degrees, 4-mm Hopkins rigid telescope into a single multifunctional unit. This three-in-one instrument is inserted through a lightweight 7.5-mm outer sheath, which is fixed separately. A fourth instrument (for example, a balloon catheter or a biopsy forceps) can be introduced and manipulated independently with the other hand. All endoscopic procedures were performed with a trephine to create a 15-mm craniotomy. After opening the dura mater, ventricles were tapped with a brain needle, which was followed by the insertion of the rigid scope for visualization. The telescope was then withdrawn momentarily; the outer sheath was introduced into the ventricle and fixed over the area of interest. The definitive procedure was then performed with ease by using the multifunctional three-in-one instrument in one hand and a fourth instrument in the other hand. This novel neuroendoscopic system has been used in clinical testing at the Vidyasagar Institute of Mental Health and Neurosciences since May 1998. Thus far, 83 neuroendoscopic procedures have been successfully performed with the aid of this instrumentation system, which has proven to be safe, versatile, and cost-effective, allowing a greater degree of freedom for the neurosurgeon.

Bipolar Microscissors

“…Hemostasis is still an important task for neurosurgeon [1], sometimes it might cause trouble during surgery, like the situation shown in Fig. 3.…”

Modified Two-Handed Transnasal Endoscopic Surgery: Innovative Instrument Design and an Experimental Canine Study

“…Compared to several irrigation-suction system designs that have previously been described, [7][8]13 our irrigation-suction system does not occupy any additional space compared to traditional surgical instruments. The design feature of adjustable irrigation and suction can help to protect native tissues, while facilitating the removal of disease, such as fungal balls, from the sinuses.…”

Spinal Cord Gliomas and Hydrocephalus: Utility of Neuroendoscopy

“…Metastatic seeding of an intramedullary astrocytoma in children has been reported on a few occasions [2,12,13]. The efficacy of neuroendoscopy in cases of obstructive hydrocephalus is widely recognized and its applications include also performing biopsies in tumoral [17][18][19] and non-tumoral lesions [20,21], in the supratentorial [17,22] and infratentorial [20,21,23] compartment. However, the role of endoscopic procedures in cases of communicating hydrocephalus is controversial [17,19,22].…”