Virtual Endoscope-Assisted Intracranial Aneurysm Surgery: Evaluation of Fifty-Eight Surgical Cases

Me, Colpan; Şekerci, Zeki; Çakmakçı, Emin; Dönmez, T.; Oral, Nezih; Dj, Mogul

doi:10.1055/s-2007-970055

Cited by 13 publications

(8 citation statements)

References 9 publications

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“…The endoscope allowed for full visualization of the CPA from cranial nerve 4 at the level of the tent to the foramen magnum as well as from the cerebellar hemispheres to the petrous temporal bone (13,14). In addition, angled endoscopes, allowed for improved visualization into the internal auditory canal (15,16,17,18,28).…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and endoscopically assisted surgeries for posterior cranial fossa lesions.

Abaza

Abedelbary

Soliman

2019

Zagazig University Medical Journal

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Background: posterior cranial fossa basal lesions including tumors and vascular compression syndromes especially located in cerebellopontine angles (CPA) are considered one of the most complex regions due to crowded anatomy and limitations of visualization during surgery by the microscope alone, so endoscopic use as assisted visualization technique helps greatly in achieving good results, better outcomes and less morbidities. The aim of this work is to assess endoscopic role and importance as assisted tool during microscopic surgery for those lesions in neurosurgery Department in Zagazig University Hospitals from October 2016 to October 2018. Methods: 33 patients included 5 cases of epidermoid, 8 cases of acoustic Schwannomas, 4 meningiomas, 10 cases of Hemifacial spasm and 6 cases of trigeminal neuralgia. in this study we used the endoscope as assisted tool to the microscope, initial dissection by the microscope then the endoscope was used to navigate in the area to detect and demonstrate the pathology and its relations to the surrounding structures, then most of the work is microscopic and the endoscope is used in different stages to detect any residuals of tumors, hidden parts, any injuries, may be used to dissect in some situations if needed, position of insulators in microvascular decompression and final view after finishing the surgery. Results: Endoscopy provided improved visualization of local anatomy, revealed hidden lesions and reduced unnecessary anatomical distortions.Conclusion: endoscopic aided technique greatly helps surgical management of CPA lesions and other disorders. This minimally invasive technique overcomes many shortcomings inherent to the traditional retrosigmoid approach. The use of the endoscope in the CPA as a tool to increase the extent of resection, minimize complications, and preserve the function of the delicate CPA structures

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Section: Discussionmentioning

confidence: 99%

Endoscopic and endoscopically assisted surgeries for posterior cranial fossa lesions.

Abaza

Abedelbary

Soliman

2019

Zagazig University Medical Journal

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“…As the typical representatives of minimally invasive neurosurgical technique, the keyhole and the endoscopic surgeries have been used widely, especially in skull base neurosurgery (2)(3)(4)(5)(6)11,12,20). The supraorbital keyhole approach is a classical keyhole approach, which has been commonly used to treat a host of disorders such as aneurysms of the anterior circulation, anterior fossa and sellar tumors, traumatic frontal lobe hematoma, etc.…”

Section: █ Discussionmentioning

confidence: 99%

Endoscopic optic nerve decompression through supraorbital keyhole extradural approach: a cadaveric study

Wang

Wu²,

Zhang³

et al. 2015

Turkish Neurosurgery

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ABSTRACTlarger trauma from the craniotomy procedure may hinder the patients to accept the approach. The endoscopic transnasal approach has an advantage of minimal invasion, but the narrow surgical corridor and potential severe bleeding reduce the popularity of the approach.For the supraorbital keyhole operation, a small incision located in the unilateral eyebrow is made and the sellar region can be reached through the intracranial natural space. Enlightened by the keyhole idea and with the aim to decrease the corresponding invasion of the conventional approaches, we tried to design a novel endoscopic approach to achieve an █ InTRODuCTIOn M any surgical approaches have been described for decompression of the optic nerve to treat traumatic optic neuropathy (14,18,21,22). The most commonly used approaches include the transcranial and the transnasal approaches (15), and each of them has specific advantages and disadvantages. The conventional transcranial approach can enable a direct access and sufficient exposure to the superior wall of the optic canal, which could help achieve an effective decompression of the optic nerve. However, the AIM: Many approaches for optic nerve decompression have their own advantages and disadvantages. The aim of this study was to perform endoscopic decompression of optic nerve through the supraorbital keyhole and evaluate its feasibility. MATERIAL and METhODS:Ten adult cadaveric heads were studied using 4-mm, 0-and 30-degree rigid endoscopes to perform the optic nerve decompression through the supraorbital keyhole extradural approach. Furthermore, the relevant measurements about the optic canal were recorded. RESuLTS:Through the supraorbital keyhole, the endoscope was introduced into the extradural space, and the following structures could be exposed and identified: the sphenoid ridge, the anterior clinoid process, the roof of the optic canal and the falciform ligament. The roof and lateral wall of the optic canal were removed using a drill under the endoscope, and more sufficient decompression could be achieved by further incising the falciform ligament and optic sheath. After measurement, the distance from the zygomatic process of the frontal bone to the optic canal was 59.32 ± 2.27 mm, the distance from the upper midpoint of the posterior foramen of the optic canal to the internal carotid artery was 3.80 ± 0.93 mm.COnCLuSIOn: According to the cadaveric study, it is feasible to perform the endoscopic decompression of optic nerve with a clear view through the supraorbital keyhole extradural approach. Our study may provide a minimally invasive and safe option for the optic nerve decompression.

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“…It provides enough visualization not only for inspection but for performing surgeries as well. Aneurysms and surrounding anatomic structures can also be depicted by 'virtual endoscopy' in three dimensions with interactive fly-through views 17 . This method can improve visualization of the aneurysm as well as increase surgical orientation.…”

Section: Endoscopic Equipmentsmentioning

confidence: 99%

Neuroendoscope in Aneurysm Surgeries

Kato¹,

Agrawal²,

Sano³

et al. 2018

jbnc

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Even with the use of most sophisticated microscope sometimes the relationship between the aneurysm and the adjacent structures are not clearly defined. The straight line of view by microscope results in inadequate visualization of structures that lie immediately behind other structures like the neck, branches or perforators of the aneurysm. Hence exposure of these structures may require risky retraction either of the parent artery or the aneurysm itself, which can be overcome by clear anatomical information obtained by the use of endoscope instead of attempting extensive manipulation under the microscope. The endoscope permits close up, wide angled views of regional anatomic features and verification of the optimal clip position. Visual conformation of regional anatomy achieved using the rigid endoscope provides valuable information for subsequent microsurgical procedures and enhances the safety and reliability. Endoscopic-assisted microsurgery is an exceptional aid and using the PIP (picture-in picture) technology, simultaneous observation of microscope and endoscopic images can be viewed through the ocular system of microscope. The advantages of neuroendoscope include the ability to look around corners and behind obstructions. With less brain retraction, smaller operative exposures and better visualization, neuroendoscopy may reduce operative morbidity. However the surgeon should be familiar with this technique and be prepared for the inconveniences and risks during the procedure.

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Virtual Endoscope-Assisted Intracranial Aneurysm Surgery: Evaluation of Fifty-Eight Surgical Cases

Cited by 13 publications

References 9 publications

Endoscopic and endoscopically assisted surgeries for posterior cranial fossa lesions.

Endoscopic and endoscopically assisted surgeries for posterior cranial fossa lesions.

Endoscopic optic nerve decompression through supraorbital keyhole extradural approach: a cadaveric study

Neuroendoscope in Aneurysm Surgeries

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