Endoscope Holders in Cranial Neurosurgery: Part I—Technology, Trends, and Implications

Paraskevopoulos, Dimitrios; Roth, Jonathan; Constantini, Shlomi

doi:10.1016/j.wneu.2016.01.052

Cited by 15 publications

(8 citation statements)

References 17 publications

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“…While several neurosurgeons use free-hand endoscopy, some prefer holders for precise, stable positioning, especially for lengthy or more complex procedures. 3,4 Freehand guidance offers flexibility but carries the risk of inadvertent movements that may result in injuring neural structures. 1 Because the endoscope is guided by the surgeon's hand at one end (proximal), it can be regarded as a lever at the distal end.…”

Section: Discussionmentioning

confidence: 99%

Specification Analysis, Design, and Prototyping of a Burr Hole Endoscope Stabilization Device

Paraskevopoulos

2016

Surg Innov

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Section: Discussionmentioning

confidence: 99%

Specification Analysis, Design, and Prototyping of a Burr Hole Endoscope Stabilization Device

Paraskevopoulos

2016

Surg Innov

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“…In general, as mentioned above, there are several difficulties in neurosurgery: limited degrees of freedom on the part of the neurosurgeon, loss of depth perception, lack of flexibility to reach anatomically complicated spots, downward drift, and brain shift, among others [14]. Due to the problems in this field, robotic systems have been used to solve some of them.…”

Section: Robotics In the Neurosurgery Fieldmentioning

confidence: 99%

Neurosurgery and brain shift: review of the state of the art and main contributions of robotics

Correa-Arana

Vivas-Albán

Navarro

2017

TecnoL.

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This paper presents a review about neurosurgery, robotic assistants in this type of procedure, and the approach to the problem of brain tissue displacement, including techniques for obtaining medical images. It is especially focused on the phenomenon of brain displacement, commonly known as brain shift, which causes a loss of reference between the preoperative images and the volumes to be treated during image-guided surgery. Hypothetically, with brain shift prediction and correction for the neuronavigation system, minimal invasion trajectories could be planned and shortened. This would reduce damage to functional tissues and possibly lower the morbidity and mortality in delicate and demanding medical procedures such as the removal of a brain tumor. This paper also mentions other issues associated with neurosurgery and shows the way robotized systems have helped solve these problems. Finally, it highlights the future perspectives of neurosurgery, a branch of medicine that seeks to treat the ailments of the main organ of the human body from the perspective of many disciplines.

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“…However, there have been various approaches to ease bimanual action by endoscope holding arms during the last decades [1,11], Friedrich et al 2019). The basic design consists of a multi-membered arm with either mechanical, pneumatic or electromagnetic locks.…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, several disadvantages have been revealed in existing products [1,11]: downwards drift of the arm, high costs of more elaborated holders, iatrogenic trauma through the fixed endonasal endoscope in the patient's head, bulky design of the arm and inflexibility through limited degrees of freedom compared to free hand movement. This might be why, by now no of the current endoscope holding devices could prevail neither in otolaryngology nor in neurosurgery.…”

Section: Introductionmentioning

confidence: 99%

A third hand to the surgeon: the use of an endoscope holding arm in endonasal sinus surgery and well beyond

Hintschich

Fischer

Seebauer

et al. 2021

Eur Arch Otorhinolaryngol

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Background Extended endoscopic endonasal operations of the sinuses and the frontal skull base require a bimanual action of the surgeon in many cases. Thus, typically an assistant guides the endoscope and centers the field of view. In this study, we investigate in which cases an endoscope holding arm can be used alternatively. Materials and methods The electromagnetic system ENDOFIXexo was used in different surgical interventions of the paranasal sinuses and beyond questioning ergonomics and geometrical limitations. The realized degrees of freedom were documented, and a topography of possible applications compiled. Results The presented system is limited by the anatomy of the anterior ethmoid and dynamic working conditions in the sagittal direction. Especially in extended interventions in the posterior ethmoid, in which parts of the nasal septum have been resected and a static position of the endoscope is desired the surgeon can greatly benefit from the robotic arm. Moreover, through the high flexibility of the endoscopic arm surgeries of the pharynx and larynx were performed, questioning the current gold standard of microscope-assisted surgical procedures. Conclusion Under the impression of an urging staff shortage and due to its unlimited patience, the ENDOFIXexo arm seems promising. Taking into account the complex anatomy and the limited access, we especially see a favorable field of application in the surgery of the pituitary gland and skull base tumors.

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Endoscope Holders in Cranial Neurosurgery: Part I—Technology, Trends, and Implications

Cited by 15 publications

References 17 publications

Specification Analysis, Design, and Prototyping of a Burr Hole Endoscope Stabilization Device

Specification Analysis, Design, and Prototyping of a Burr Hole Endoscope Stabilization Device

Neurosurgery and brain shift: review of the state of the art and main contributions of robotics

A third hand to the surgeon: the use of an endoscope holding arm in endonasal sinus surgery and well beyond

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