Evaluation of Bendable Surgical Suction Devices Made of Shape-Memory Alloy for the Endonasal Transsphenoid Removal of Pituitary Tumors

Grunert, Ronny; Klietz, Sandra; Gardner, Paul A.; Fernández-Miranda, Juan C.; Snyderman, Carl H.

doi:10.1177/014556131809701211

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…Overall, only 7 out of 62 studies report outcomes or comments relating to the ergonomics of the instrument ( Supplementary Table S3 ). Comment on instrument ergonomics featured in six studies of six instruments: the Suction Device made of Shape Memory Alloy connected to the ATOM5 Record 55 DDS [ 68 ], the Malleable Endoscope Suction Instrument [ 34 ], the Monoshaft Bipolar Cautery [ 42 ], the Bipolar Microscissors [ 17 ], the Sonopet Ultrasonic Bone Aspirator [ 66 ] and the Handpiece, Keyhold and Needle-Type Probes and Probe Sheaths for use with the Ultrasonic Surgical Unit [ 31 ]. One study reported administering a seven-question survey in which surgeons rated the ergonomics of the final instrument design as “very good” [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

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

Aylmore

Dimitrakakis

Carmichael

et al. 2022

Cancers

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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.

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Section: Resultsmentioning

confidence: 99%

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

Aylmore

Dimitrakakis

Carmichael

et al. 2022

Cancers

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“…In a previous work, the ergonomic design was evaluated by an experienced skull base neurosurgeon. 19 The handpiece was combined with a cuboid tracker. A special colored test pattern FIG.…”

Section: Mixed Reality Hololens Navigation Systemmentioning

confidence: 99%

IMAGINER: improving accuracy with a mixed reality navigation system during placement of external ventricular drains. A feasibility study

Grunert,

Winkler,

Wach

et al. 2024

Neurosurgical Focus

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OBJECTIVE The placement of a ventricular catheter, that is, an external ventricular drain (EVD), is a common and essential neurosurgical procedure. In addition, it is one of the first procedures performed by inexperienced neurosurgeons. With or without surgical experience, the placement of an EVD according to anatomical landmarks only can be difficult, with the potential risk for inaccurate catheter placement. Repeated corrections can lead to avoidable complications. The use of mixed reality could be a helpful guide and improve the accuracy of drain placement, especially in patients with acute pathology leading to the displacement of anatomical structures. Using a human cadaveric model in this feasibility study, the authors aimed to evaluate the accuracy of EVD placement by comparing two techniques: mixed reality and freehand placement. METHODS Twenty medical students performed the EVD placement procedure with a Cushing’s ventricular cannula on the right and left sides of the ventricular system. The cannula was placed according to landmarks on one side and with the assistance of mixed reality (Microsoft HoloLens 2) on the other side. With mixed reality, a planned trajectory was displayed in the field of view that guides the placement of the cannula. Subsequently, the actual position of the cannula was assessed with the help of a CT scan with a 1-mm slice thickness. The bony structure as well as the left and right cannula positions were registered to the CT scan with the planned target point before the placement procedure. CloudCompare software was applied for registration and evaluation of accuracy. RESULTS EVD placement using mixed reality was easily performed by all medical students. The predefined target point (inside the lateral ventricle) was reached with both techniques. However, the scattering radius of the target point reached through the use of mixed reality (12 mm) was reduced by more than 54% compared with the puncture without mixed reality (26 mm), which represents a doubling of the puncture accuracy. CONCLUSIONS This feasibility study specifically showed that the integration and use of mixed reality helps to achieve more than double the accuracy in the placement of ventricular catheters. Because of the easy availability of these new tools and their intuitive handling, we see great potential for mixed reality to improve accuracy.

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“…In a previous work, the ergonomic design was already evaluated by an experienced skull base neurosurgeon. 18 The handpiece was combined with a cuboid tracker. A special-colored test pattern was placed on each cuboid surface so that the instrument could be recognized by the sensors of the Hololens 2 (Figure 2).…”

Section: Surgical Pointer Instrumentmentioning

confidence: 99%

NextLens—The Next Generation of Surgical Navigation: Proof of Concept of an Augmented Reality System for Surgical Navigation

Grunert

Snyderman

Gardner

et al. 2023

J Neurol Surg B Skull Base

Self Cite

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Objective: The aim of this work was the development of an augmented reality system including the functionality of conventional surgical navigation systems. Methods: An application software for the Augmented Reality System Hololens 2 from Microsoft was developed. It detects the position of the patient as well as position of surgical instruments in real-time and displays it within the 2D-MRI or CT images. The surgical pointer instrument, including a pattern which is recognized by the Hololens 2 sensors, was created with 3D-printing. The tech-nical concept was demonstrated at a cadaver skull to identify anatomical landmarks. Results: With the help of the Hololens 2 and its sensors, the real-time position of the surgical point-er instrument could be shown. The position of the 3D-printed pointer with colored pattern could be recognized within 2D-CT images when stationary and in motion at a cadaver skull. Feasibility could be demonstrated for the clinical application of transsphenoidal pituitary surgery. Conclusion: The Hololens 2 has a high potential for use as a surgical navigation system. With sub-sequent studies, a further accuracy evaluation will be performed receiving valid data for compari-son with conventional surgical navigation systems. In addition to transsphenoidal pituitary surgery, it could be also applied for other surgical disciplines.

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Evaluation of Bendable Surgical Suction Devices Made of Shape-Memory Alloy for the Endonasal Transsphenoid Removal of Pituitary Tumors

Cited by 4 publications

References 9 publications

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

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

IMAGINER: improving accuracy with a mixed reality navigation system during placement of external ventricular drains. A feasibility study

NextLens—The Next Generation of Surgical Navigation: Proof of Concept of an Augmented Reality System for Surgical Navigation

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