Endoscope-assisted Brain Surgery: Part 1—Evolution, Basic Concept, and Current Technique

Abstract

With the knowledge of almost all individual anatomic and pathoanatomic details of a specific patient, it is possible to target the individual lesion through a keyhole approach using the particular anatomic windows. As the light intensity and the depiction of important anatomic details are improved by the intraoperative use of lens scopes, endoscope-assisted microsurgery during keyhole approaches may provide maximum efficiency to remove the lesion, maximum safety for the patient, and minimum invasiveness.

An electrophysiological study on the safety of the endoscope-assisted microsurgical removal of vestibular schwannomas

“…Its application in various skull base procedures, either as a sole visualizing tool or as an adjunct to the microscope, is constantly expanding [1]. The endoscope provides superior illumination and magnification, as well as possibility "to look around the corner", thus allowing for more radical but safe surgeries [2]. The endoscope-assisted microsurgery (EAM) combines the advantages of both the classical microneurosurgery and endoscopy.…”

Supraorbital Keyhole Craniotomy in Surgery of Intra- And Extra-Axial Brain Tumors

“…Наши результаты, а также публикации других ав-торов, свидетельствуют о том, что супраорбитальная keyhole краниотомия может выполняться при самой различной внутричерепной патологии, включая опу-холи ПЧЯ и аневризмы, как в остром периоде кро-воизлияния, так и при аневризме без разрыва [8][9][10][11][16][17][18][19][20][21][22][23]. При правильном подходе к выбору кандидатов на keyhole доступ супраорбитальная краниотомия через кожный разрез по брови обеспечивает более прямоли-нейный доступ к новообразованиям ПЧЯ, а при до-стижении достаточного опыта выполнение доступа занимает 12-15 мин.…”

Transsphenoidal endoscopic skull base surgery: state of the art and future perspective

“…Unlike the microscope, the endoscope has no change in light intensity when transitioning to a more magnified view [ 107 ]. Its mobility and angled lenses allow up-close views of regions behind or adjacent to tissue barriers poorly visualized or unseen with the microscope, such as folds of the diaphragma sella during macroadenoma removal, medial cavernous sinus, suprasellar and retrochiasmal space, prepontine cistern, lateral sphenoid recess and Meckel ' s cave.…”