Abstract
PurposeWe assessed the applicability of a new multidirectional videoendoscope (digiCAMeleon, Karl Storz GmbH, Tuttlingen, Germany) in various neuroendoscopic procedures.MethodsA 4-mm-diameter rigid videoendoscope (digiCAMeleon, Karl Storz GmbH, Tuttlingen, Germany) with 1 sensor and an internal LED light source was tested. The device offers a resolution of 1920 x 1080 pixels and weighs ≈ 215 g. The prototype was tested on three cadaveric heads using three different approaches: a) endoscopic endonasal transsphenoidal; b) frontal transcortical intraventricular; c) supraorbital.ResultsWe identified several major benefits of the integrated system as applied to endoscopic endonasal, transcortical intraventricular, and endoscopic supraorbital keyhole approaches. These included improved maneuverability of the scope on account of reduced bulk and integration of the camera and fiberoptic light components, a variable angle of view from 0–70 degrees, and a novel feature that can be activated to maintain orientation of the surgical horizon. Our preliminary report highlights the potential for handling the videoendoscope in one hand, as one would a microsurgical instrument. The videoendoscope harbors all its electronic and lighting data into a unique and thin cable, thus resembling a modern "all-in-one" computer technology. Because of its reduced weight and ergonomic shape, controlling its movements is very easy and comfortable, even in the microsurgical environment. Furthermore, the videoendoscope offers the unique feature of orienting the horizon of vision, thanks to the possibility of offering angled views while working; this helps the surgeons to stay oriented with direct visualization and improved control of the instruments over a specific area of interest.ConclusionsThe videoendoscope prototype represents an HD-image quality versatile tool in a neurosurgical environment, thanks to its reduced weight and dimensions; in these preliminary simulations, we have identified optimized visibility and maneuverability as major benefits of this novel surgical adjunct.
Highlights
The endoscope was first introduced in neurosurgery in the early decades of the 20th century and since it has gradually become part of the neurosurgeon’s armamentarium, thanks to enormous technological progress and ongoing refinements
We identified several major benefits of the integrated system as applied to endoscopic endonasal, transcortical intraventricular, and endoscopic supraorbital keyhole approaches
Our preliminary report highlights the potential for handling the videoendoscope in one hand, as one would a microsurgical instrument
Summary
The endoscope was first introduced in neurosurgery in the early decades of the 20th century and since it has gradually become part of the neurosurgeon’s armamentarium, thanks to enormous technological progress and ongoing refinements. A new subspecialty in neurosurgery (i.e. neuroendoscopy) has developed as a result of the versatility and applicability of the neuroendoscope to a multitude of neurosurgical approaches. The 1960's represented a time during which publications on neuroendoscopy were sparse, it was a time when key technological advances were made, laying the groundwork for the future reinassance of neuroendoscopy. These technological advances included the idea of variable refractive index lenses by Harold Hopkins (i.e. the SELFOC lens), the invention of charged-coupling devices (CCDs) and improved fiberoptic technology [3]. The introduction of advanced optical systems, which reduced loss of reflected light and tremendously improved video-capture methods, cultivated an increased interest in the field of neuroendoscopy over the last decades
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