A transparent sheath for endoscopic surgery and its application in surgical evacuation of spontaneous intracerebral hematomas

Nishihara, Tatsuro; Teraoka, Akira; Morita, Akio; Ueki, Keisuke; Takai, Keisuke; Kirino, Takaaki

doi:10.3171/jns.2000.92.6.1053

Cited by 117 publications

(61 citation statements)

References 11 publications

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“…1,3,4,[8][9][10][11][12][13][14] Table 2 summarizes the surgical indications, timing, technique, and results of the endoscope-assisted methods of ICH evacuation as reported in different series.…”

Section: Comparison With Different Methods Of Endoscope-assisted Ich mentioning

confidence: 99%

Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term results

Kuo

Chen²,

et al. 2011

FOC

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Object Currently, the effectiveness of minimally invasive evacuation of intracerebral hemorrhage (ICH) utilizing the endoscopic method is uncertain and the technique is considered investigational. The authors analyzed their experience with this method in terms of case selection, surgical technique, and long-term results. Methods The authors performed a retrospective analysis of the clinical and radiographic data obtained in 68 patients treated with endoscope-assisted ICH evacuation. Rebleeding, morbidity, and mortality were recorded as primary end points. Hematoma evacuation rate was calculated by comparing the pre- and postoperative CT scans. Glasgow Coma Scale scores and scores on the extended Glasgow Outcome Scale (GOSE) were recorded at the 6-month postoperative follow-up. The technical aspect of this report explains details of the procedure, the instruments that are used, the methods for hemostasis, and the role of hemostatic agents in the management of intraoperative hemorrhage. The pertinent literature was reviewed and summarized. Results All surgeries were performed within 12 hours of ictus, and 84% of the surgeries were performed within 4 hours. The mortality rate was 5.9%, and surgery-related morbidity occurred in 3 cases (4.4%). The hematoma evacuation rate was 93% overall—96% in the putaminal group, 86% in the thalamic group, and 98% in the subcortical group. The rebleeding rate was 1.5%. The mean operative time was 85 minutes, and the average blood loss was 56 ml. The mean GOSE score was 4.9 at 6-month follow-up. The authors acknowledge the limitations of these preliminary results in a small number of patients. Conclusions The data suggest that early endoscope-assisted ICH evacuation is safe and effective in the management of supratentorial ICH. The rebleeding, morbidity, and mortality rates are low compared with rates reported in the literature for the traditional craniotomy method. This study also showed that early and complete evacuation of ICH may lead to improved outcomes in selected patients. However, the safety and efficacy of endoscope-assisted ICH evacuation should be further investigated in a large, prospective, randomized trial.

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Section: Comparison With Different Methods Of Endoscope-assisted Ich mentioning

confidence: 99%

Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term results

Kuo

Chen²,

et al. 2011

FOC

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“…The endoscopic evacuation of ICHs has some disadvantages with respect to other surgical techniques: 1) Visualization is not occasionally adequate, especially when there is a hemorrhage during the procedure [40,41,[46][47][48][49][50]. 2) The restricted working space limits the maneuverability of the instruments and the control of a possible bleeding [48].…”

Section: Considerations About Results Of Endoscopic Evacuationmentioning

confidence: 99%

Evacuation of intracerebral hemorrhages by neuroendoscopy with transparent sheath. Experimental study

Otero-Rodríguez

Gonçalves

Sánchez-Ledesma

et al. 2015

Interdisciplinary Neurosurgery

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“…2,7,8) Our technique and experience may solve these functional and technical problems. 9,10) Next, we will evaluate the long-term outcomes in patients who underwent the freehand technique, and develop new endoscopic tools.…”

Section: Discussionmentioning

confidence: 99%

Freehand Technique for Putaminal Hemorrhage-Technical Note-

Yokosuka

Uno

Hirano

et al. 2011

Neurol. Med. Chir.(Tokyo)

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We designed a new endoscopic surgical procedure for putaminal hemorrhage (freehand technique) and evaluated its effectiveness and safety in patients with putaminal hemorrhage. Computed tomography (CT) data sets from 40 healthy patients were used. The CT data were transformed into three-dimensional images using AZE VirtualPlace TM Plus. The nasion and external auditory foramen were the intraoperative reference points. The median point from medial of the globus pallidus to the insula was the target point. The location of the burr hole point was 80-125 mm above and 27.5 mm lateral to the nasion, and the direction was parallel to the midline and a line drawn from the burr hole to the ipsilateral external auditory foramen. This point was used for 15 patients with putaminal hemorrhage. In all cases, only one puncture was required, and there were no complications. The median surgical time was 91.7 minutes, and the median hematoma removal rate was 95.9%. No recurrent bleeding or operative complications occurred. The freehand technique is a simple and safe technique for patients with putaminal hemorrhage. We believe that this technique of endoscopic hematoma evacuation may provide a less-invasive method for treating patients with putaminal hemorrhage.

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A transparent sheath for endoscopic surgery and its application in surgical evacuation of spontaneous intracerebral hematomas

Cited by 117 publications

References 11 publications

Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term results

Early endoscope-assisted hematoma evacuation in patients with supratentorial intracerebral hemorrhage: case selection, surgical technique, and long-term results

Evacuation of intracerebral hemorrhages by neuroendoscopy with transparent sheath. Experimental study

Freehand Technique for Putaminal Hemorrhage-Technical Note-

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