Three‐dimensional endoscopy in transnasal transsphenoidal approach to clival chordomas

Garzaro, Massimiliano; Zenga, Francesco; Raimondo, Luca; Pacca, Paolo; Pennacchietti, Valentina; Riva, Giuseppe; Ducati, Alessandro; Pecorari, Giancarlo

doi:10.1002/hed.24324

Cited by 16 publications

(18 citation statements)

References 45 publications

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“…Comparisons between the two endoscopes (Table I) found no evidence of significant differences between the time (P = .153) or the adjustment time (P = .067), although the trend was for the latter to be longer in the 3D endoscopes irrespective of whether using this endoscope first or second. However, past pointing was found to be significantly lower when using 3D endoscopes (median 0 vs. 2, P = .025), and depth perception (8 vs. 4, P < .001) Adjustment Time (seconds) 9 (5-13) 10 (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) .067…”

Section: Resultsmentioning

confidence: 99%

“…Recently, multiple studies have shown subjective improvements in precision of anatomy identification, stereoscopic depth perception, and surgical comfort. 2,[10][11][12] Despite this, there has been minimal objective data collection with small studies highlighting postoperative outcomes, length of hospital stay, quantity of blood loss, and complication rates comparable to standard 2D techniques. 10,13 Additionally, Van Gompell et al 14 documented a 52% field of view restriction with a different 3D endoscope in 2014.…”

Section: Introductionmentioning

confidence: 99%

“…We conducted a study aimed at junior doctors and medical students with little to no endoscopic experience using both objective and subjective measures. 2,6,7,9,[11][12][13][14]…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic training—is the future three‐dimensional?

Nassimizadeh

Zaidi

Nassimizadeh³

et al. 2018

Laryngoscope Investig Oto

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Background/ObjectivesEndoscopic surgery has a distinct disadvantage compared to direct vision: loss of binocular vision. Three‐dimensional endoscopy has been welcomed due to the promise of improving stereopsis.MethodsProspective randomized study of junior doctors with minimal endoscopic experience, using both two‐dimensional and three‐dimensional, zero‐degree, 4‐mm Storz endoscopes. Data was collected using validated, standardized training models, both objectively and subjectively. Paired comparisons between variables relating to the endoscopes were performed using Wilcoxon's tests. Operators were then split into groups based on their endoscope preference, with comparisons made using Mann‐Whitney tests for Likert scale responses, Kendall's tau for ordinal variables, and Fisher's exact tests for nominal variables.ResultsReduction of field of vision of three‐dimensional endoscopy by 2%. Significant findings included decreased past‐pointing, improved depth and perception and image quality.ConclusionThe use of an endoscopic endonasal approach with three‐dimensional technology has measurable advantages for novice users, and highlights potential tailoring of future surgical trainingLevel of Evidence1b

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic training—is the future three‐dimensional?

Nassimizadeh

Zaidi

Nassimizadeh³

et al. 2018

Laryngoscope Investig Oto

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“…Over the past decades, endoscopic imaging techniques and endoscopic surgery expertise have improved continuously. Today, a wide range of sinonasal and skull base pathology can be treated successfully with endoscopic endonasal surgery (EES) . In EES, two‐dimensional (2D) high‐definition (HD) endoscopes are widely used, and although they provide good quality images of the surgical field, depth perception is limited compared with direct sight or use of a surgical microscope .…”

Section: Introductionmentioning

confidence: 99%

“…Today, a wide range of sinonasal and skull base pathology can be treated successfully with endoscopic endonasal surgery (EES). 1,2 In EES, two-dimensional (2D) high-definition (HD) endoscopes are widely used, and although they provide good quality images of the surgical field, depth perception is limited compared with direct sight or use of a surgical microscope. 3,4 Specifically during extended EES procedures, when detailed display of anatomical relations is required, the limited depth perception is thought to limit surgical performance.…”

Section: Introductionmentioning

confidence: 99%

The effect of three‐dimensional visualisation on performance in endoscopic sinus surgery: A clinical training study using surgical navigation for movement analysis in a randomised crossover design

Dam

Helder

Laan

et al. 2020

Clinical Otolaryngology

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Objectives Endoscopic imaging techniques and endoscopic endonasal surgery (EES) expertise have evolved rapidly. Only few studies have assessed the effect of three‐dimensional (3D) endoscopy on endoscopic sinus surgery (ESS). The present study aimed to objectively and subjectively assess the additional value of 3D high‐definition (HD) endoscopy in ESS. Design A randomized crossover study of endoscopic surgery performance, using five ESS tasks of varying complexity, performed on Thiel embalmed human specimens. Setting Simulated surgical environment. Participants Thirty participants, inexperienced in ESS. Main outcome measures Performance was assessed using video imaging, surgical navigation and questionnaires. Main outcome measures were as follows: efficiency (defined by time to task completion), distance covered inside the nose, average velocity towards target, accuracy (measured by error rate), and subjective assessment of endoscope characteristics. Results During ESS tasks, both efficiency and accuracy did not differ significantly between 2D HD and 3D HD endoscopy. Subjectively, imaging characteristics of the 3D HD endoscope were rated significantly better. Conclusions ESS performance of inexperienced participants was not significantly improved by the use of 3D HD endoscopy during ESS tasks, although imaging characteristics of the 3D HD endoscope were rated significantly better. Surgical field characteristics and surgical techniques are likely to influence any additional value of 3D HD endoscopy.

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ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

137

262

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Three‐dimensional endoscopy in transnasal transsphenoidal approach to clival chordomas

Abstract: No discomfort was recorded; when a dura opening was required, 3D vision allowed an accurate intradural sharp dissection and a precise repair of the skull base. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1814-E1819, 2016.

Cited by 16 publications

References 45 publications

Endoscopic training—is the future three‐dimensional?

Endoscopic training—is the future three‐dimensional?

The effect of three‐dimensional visualisation on performance in endoscopic sinus surgery: A clinical training study using surgical navigation for movement analysis in a randomised crossover design

ICAR: endoscopic skull‐base surgery

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