Preliminary experience with 4K ultra-high definition endoscope: analysis of pros and cons in skull base surgery

Rigante, Mario; Rocca, Giuseppe La; Lauretti, Liverana; D’Alessandris, Quintino Giorgio; Mangiola, Annunziato; Anile, Carmelo; Olivi, Alessandro; Paludetti, Gaetano

doi:10.14639/0392-100x-1684

Cited by 39 publications

(14 citation statements)

References 4 publications

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“…The camera is the eye of the surgeon! Compared to old low-resolution scopes, modern laparoscopes provide high-resolution images enabling the smooth performance of complex and delicate procedures[ 55 , 56 ]. The assistant holding the camera is responsible for providing a clear, focused image to the surgeon.…”

Section: Peri-operative Considerationsmentioning

confidence: 99%

Safety considerations in laparoscopic surgery: A narrative review

Madhok¹,

Nanayakkara²,

Mahawar³

2022

WJGE

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Laparoscopic surgery has many advantages over open surgery. At the same time, it is not without its risks. In this review, we discuss steps that could enhance the safety of laparoscopic surgery. Some of the important safety considerations are ruling out pregnancy in women of the childbearing age group; advanced discussion with the patient regarding unexpected intraoperative situations, and ensuring appropriate equipment is available. Important perioperative safety considerations include thromboprophylaxis; antibiotic prophylaxis; patient allergies; proper positioning of the patient, stack, and monitor(s); patient appropriate pneumoperitoneum; ergonomic port placement; use of lowest possible intra-abdominal pressure; use of additional five-millimetre (mm) ports as needed; safe use of energy devices and laparoscopic staplers; low threshold for a second opinion; backing out if unsafe to proceed; avoiding hand-over in the middle of the procedure; ensuring all planned procedures have been performed; inclusion of laparoscopic retrieval bags and specimens in the operating count; avoiding 10-15 mm ports for placement of drains; appropriate port closures; and use of long-acting local anaesthetic agents for analgesia. Important postoperative considerations include adequate analgesia; early ambulation; careful attention to early warning scores; and appropriate discharge advice.

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Section: Peri-operative Considerationsmentioning

confidence: 99%

Safety considerations in laparoscopic surgery: A narrative review

Madhok¹,

Nanayakkara²,

Mahawar³

2022

WJGE

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“…The most recent visualization technologies (e.g. 3D and 4K cameras), angled instruments 49 and their different applications aided also by navigation systems contributed to the fact that the endoscopic endonasal approach become the best surgical approach to treat CSF leaks by offering the best surgical outcomes. This approach allows achieving success rates of almost 95%, and reduces significantly patient morbidity if performed by highly skilled surgeons 22 .…”

Section: Discussionmentioning

confidence: 99%

Trattamento delle fistole rinoliquorali: quando è richiesto un approccio chirurgico multidisciplinare al basicranio?

Galli

Morelli

Rigante

et al. 2021

Acta Otorhinolaryngol Ital

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Cerebrospinal fluid (CSF) leak remains a rare condition, characterized by serious complications and potentially fatal. According to different etiologies, CSF leaks may be classified into two main categories: traumatic and spontaneous. Spontaneous fistulas seem to be mainly related to obesity and idiopathic intracranial hypertension. Diagnosis is both clinical and radiological. During the last three decades, surgical treatment has mostly shifted to endonasal endoscopic approach, which widely demonstrated to be more effective than invasive intracranial ones. Post-operative complications, long-term sequelae and hospital stay are strongly reduced thanks to endoscopic approach. The diagnosis and treatment of CSF leaks represent a difficult and challenge task. The main effort seems to be related to the precise localization of the leak. An accurate assessment of both predisposing factors and comorbidities is mandatory in case of spontaneous leaks. However, a clinical multidisciplinary evaluation as well as treatment, is essential to decrease the rate of failure of surgery. The presence of a dedicated instruments, the Skull Base Team, the knowledge of reconstructive materials and techniques represents a decisive result in therapeutical management even if for each patient an effective therapeutic algorithm can be obtained considering the correct leak detection and characteristics. In conclusion the strict teamwork with neurosurgeons, neuroradiologists, ophtalmologists will enable the development also of innovative biomaterials, which could spread and standardize multi-layer techniques, nowadays still related to surgeon preferences.

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“…Therefore, we decided to repair the spheno-nasopharyngeal cephalocele using a transsphenoidal approach. Indeed, despite the continuous advancement of technical surgeries, transsphenoidal approach is still considered the gold standard for skull base surgery [40][41][42][43]. According to Yang et al, the transsphenoidal approach may be the optimal treatment for the management of many symptoms related to transsphenoidal cephaloceles, and patients with milder preoperative symptoms have a better prognosis [43].…”

Section: Discussionmentioning

confidence: 99%

A rare triad of morning glory disc anomaly, moyamoya vasculopathy, and transsphenoidal cephalocele: pathophysiological considerations and surgical management

et al. 2021

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Morning glory disc anomaly is a congenital abnormality of the optic disc and peripapillary retina reported as an isolated condition or associated with various anomalies, including basal encephaloceles and moyamoya vasculopathy. However, the co-occurrence of these three entities is extremely rare and the pathogenesis is still poorly understood. Moreover, data on the surgical management and long-term follow-up of the intracranial anomalies are scarce. Here, we describe the case of a 11-year-old boy with morning glory disc anomaly, transsphenoidal cephalocele, and moyamoya vasculopathy, who underwent bilateral indirect revascularization with encephalo-duro-myo-arterio-pericranio-synangiosis at the age of 2 years, and endoscopic repair of the transsphenoidal cephalocele at the age of 6 years. A rare missense variant (c.1081T>C,p.Tyr361His) was found in OFD1, a gene responsible for a X-linked ciliopathy, the oral-facial-digital syndrome type 1 (OFD1; OMIM 311200). This case expands the complex phenotype of OFD1 syndrome and suggests a possible involvement of OFD1 gene and Shh pathway in the pathogenesis of these anomalies.

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Preliminary experience with 4K ultra-high definition endoscope: analysis of pros and cons in skull base surgery

Cited by 39 publications

References 4 publications

Safety considerations in laparoscopic surgery: A narrative review

Safety considerations in laparoscopic surgery: A narrative review

Trattamento delle fistole rinoliquorali: quando è richiesto un approccio chirurgico multidisciplinare al basicranio?

A rare triad of morning glory disc anomaly, moyamoya vasculopathy, and transsphenoidal cephalocele: pathophysiological considerations and surgical management

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