A review of common endoscopic intracranial approaches

Darbar, Aneela; Mustansir, Fatima; Hani, Ummey; Sajid, Mir Ibrahim

doi:10.4103/ajns.ajns_367_19

Cited by 4 publications

(3 citation statements)

References 86 publications

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“…Historically, the most important indications for endoscopic cranial neurosurgery are transsphenoidal or subfrontal approaches to the sellar region and to the anterior skull base ( 2 , 13 ). A further indication in patients with occlusive hydrocephalus is the approach to and the opening of the floor of the third ventricle ( 10 , 11 ).…”

Section: Discussionmentioning

confidence: 99%

“…Over the past decades, technical innovations in direct and indirect intraoperative visualization have significantly changed surgical approaches as well as dissection strategies. Among these visual adjuncts, neuro-endoscopes have become well-established tools, particularly in the transsphenoidal surgery of intra- and parasellar lesions ( 1 – 3 ) at the anterior skull base ( 4 – 9 ) or for alternative drainage in occlusive hydrocephalus ( 2 , 10 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic Assistance in the Deep and Narrow Spaces of the Brain—Microscopic Tumor Surgery Supported by the New Micro-Inspection Tool QEVO® (Technical Note)

et al. 2021

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Introduction: To evaluate the feasibility and efficacy of the innovative micro-inspection tool QEVO® (Carl Zeiss Meditec, Oberkochen, Germany) as an endoscopic adjunct to microscopes for better visualization of the surgical field in complex deep-seated intracranial tumors in infants and adults.Materials and Methods: We retrospectively assessed the surgical videos of 25 consecutive patients with 26 complex intracranial lesions (time frame 2018–2020). Lesions were classified according to their anatomical area: 1 = sellar region (n = 6), 2 = intra-ventricular (except IV.ventricle, n = 9), 3 = IV.ventricle and rhomboid fossa (n = 4), and 4 = cerebellopontine angle (CPA) and foramen magnum (n = 7). Indications to use the QEVO® tool were divided into five “QEVO® categories”: A = target localization, B = tailoring of the approach, C = looking beyond the lesion, D = resection control, and E = inspection of remote areas.Results: Overall, the most frequent indications for using the QEVO® tool were categories D (n = 19), C (n = 17), and E (n = 16). QEVO® categories B (n = 8) and A (n = 5) were mainly applied to intra-ventricular procedures (anatomical area 2).Discussion: The new micro-inspection tool QEVO® is a powerful endoscopic device to support the comprehensive visualization of complex intracranial lesions and thus instantly increases intraoperative morphological understanding. However, its use is restricted to the specific properties of the respective anatomical area.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endoscopic Assistance in the Deep and Narrow Spaces of the Brain—Microscopic Tumor Surgery Supported by the New Micro-Inspection Tool QEVO® (Technical Note)

et al. 2021

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“…Clinically, fully exposing the central thalamic lesions while minimizing damage to the surrounding brain structure is the key to the surgery. Using the neuroendoscopy technology can improve the illumination of the surgical eld, better de ne anatomical details, and provide a closer view to observe the tumor-tissue interface, thereby increasing the precision of the operation [9,12,13]. However, the endoscopic approach also has limitations, including restricted movements of the instruments, a visual eld frequently obscured by intraoperative bleeding, and the inability to use a two-handed technique [17].…”

Section: Introductionmentioning

confidence: 99%

Safety and Efficacy of Neuronavigation via Middle Frontal Gyrus Endoport-assisted Endoscopic Resection for Thalamic Lesions

Liu

Xie

Yang

et al. 2021

Preprint

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BackgroundSurgery for thalamic lesions is generally challenging because they are deep-seated and surrounded by vital neurovascular structures. Whether neuronavigation via middle frontal gyrus endoport-assisted endoscopic resection for thalamic lesions is safe and effective remains to be further evaluated.Materials and MethodsTwelve patients treated surgically were retrospectively reviewed using the neuronavigation endoport-assisted endoscopy between January 2016 and April 2021 at Zhongshan Hospital of Fudan University. Preoperative and tumor-related variables, as well as postoperative outcomes, were also collected.ResultsAll lesions located in the medial part of the thalamus, and some of them expanded forward, downward, or backward. The median size of lesions was 29 mm (range 16-56 mm). The final pathology results showed 4 cases of benign lesions, 4 cases of low-grade glioma, and 4 cases of glioblastoma. All of the cases with benign lesions and low-grade glioma (100%) achieved GTR, while 3/4 (75%) of cases with glioblastoma achieved NTR, and 1 (25%) case obtained STR. None of the patients in this study have postoperative seizures. In the benign lesions and low-grade glioma group, worse Karnofsky performance status scores at discharge were 25%, and all achieved long-term postoperative survival. For patients with glioblastoma, 3/4 cases had worse Karnofsky performance status scores at discharge, and died within 6 months. ConclusionCombining the advantages of neuronavigation, endoscopy, and endoport techniques via the middle frontal gyrus approach can safely and effectively remove benign lesions and low-grade glioma in the medial part of the thalamus.

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Neuronavigation-Guided Transcortical-Transventricular Endoport-Assisted Endoscopic Resection for Thalamic Lesions: Preliminary Experience

Liu

Xie

et al. 2022

World Neurosurgery

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A review of common endoscopic intracranial approaches

Cited by 4 publications

References 86 publications

Endoscopic Assistance in the Deep and Narrow Spaces of the Brain—Microscopic Tumor Surgery Supported by the New Micro-Inspection Tool QEVO® (Technical Note)

Endoscopic Assistance in the Deep and Narrow Spaces of the Brain—Microscopic Tumor Surgery Supported by the New Micro-Inspection Tool QEVO® (Technical Note)

Safety and Efficacy of Neuronavigation via Middle Frontal Gyrus Endoport-assisted Endoscopic Resection for Thalamic Lesions

Neuronavigation-Guided Transcortical-Transventricular Endoport-Assisted Endoscopic Resection for Thalamic Lesions: Preliminary Experience

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