Endoscopic Minimally Invasive Neurosurgery: Emerging Techniques and Expanding Role through an Extensive Review of the Literature and Our Own Experience – Part I: Intraendoscopic Neurosurgery

Abstract

Background/Aims: Minimally invasive neurosurgery is a growing field, more so in recent decades. The modernization of tools, especially the endoscope, has allowed for critical improvements and crucial advancements in minimally invasive neurosurgery. The current classification scheme for endoscopic procedures needs to be updated to reflect these advancements. Methods: Although the field of neuroendoscopy is continually evolving, the terminologies utilized to describe endoscopic procedures reflect and favor its use as mostly an assisting device complementing the microscope. Even though the classification was adequate for its time, it has become inexact and therefore confusing. We therefore propose a new classification scheme that encompasses the growing independence of endoscopic minimally invasive neurosurgery (EMIN) as well as the changing landscape within EMIN procedures. Results: We have classified our EMIN procedures, since 2002, as either ‘intraendoscopic’ (IEN) or ‘extraendoscopic’ (XEN) in relation to the endoscope’s axis. Exemplary cases of IEN and a review of the literature are presented as well. Conclusion: Our proposed classification scheme for solely endoscopic procedures is presented. The role of the endoscope as an independent tool is clarified.

Clinical Uses of Diffusion Tensor Imaging Fiber Tracking Merged Neuronavigation with Lesions Adjacent to Corticospinal Tract : A Retrospective Cohort Study

“…Maximizing the surgical resection of tumors in eloquent brain areas while minimizing injury to vulnerable cortex and white matter tracts remains a challenge, given the considerable risk to related corticospinal tracts (CSTs) 3) . Although microinvasive techniques have drastically improved chances of surgical success 8,11,20) , white matter tracts may at times sustain injury, culminating in severe neurologic deficits and poor outcomes.…”

Fully endoscopic posterior fossa decompression for Chiari malformation type I: illustrative case

“…[15][16][17] Endoscopic neurosurgery supports the concept of minimally invasive neurosurgery, whose main principle is to use as minimally invasive an approach as possible while maintaining sufficient surgical effect. [18][19][20] The case we have described shows that surgery for CM-I can be performed as a fully endoscopic microsurgical procedure. Based on the clinical anatomical study by Dolas et al, 14 a similar operation was performed.…”

“…Endoscopic neurosurgery supports the concept of minimally invasive neurosurgery, whose main principle is to use as minimally invasive an approach as possible while maintaining sufficient surgical effect. 18–20 …”

The history of neurosurgery and its relation to the development and refinement of the frontotemporal craniotomy

“…Multiple studies have demonstrated the benefits of their use as an adjunct to or a replacement for the operative microscope, depending on the procedure. 2,3,23,24,46 Recent studies have developed an ever-expanding list of pathologies accessible endoscopically, especially through the endonasal corridor. 37,56,65 As these approaches mature, endoscopy will become a more commonly used technology to aid the neurosurgeon in the operating room, just as the microscope did a generation ago.…”