Use Of Endoscopic Surgery Research Articles

A narrative review of endoscopic spine surgery: history, indications, uses, and future directions.

The concept of endoscopic surgery began in the 1930s and has since undergone numerous advancements in both technology and surgical indications. Its main benefit is providing the opportunity to perform surgery while minimizing disruption to surrounding structures. The purpose of this review is to summarize the history, uses, and future directions for spine endoscopic surgery. A review of national databases was performing using key terms "endoscopic", "spine" and "surgery" for literature from 1900 to 2023. Studies that aimed to describe the utilities of endoscopic surgeries, associated outcomes, limitations, and future directions were included. Studies that were not in English were excluded. This review includes a brief overview of the history of endoscopic surgery and its current two main approaches, transforaminal and interlaminar approaches. It then summarizes the main indications and utilization of endoscopic surgery in the lumbar, cervical and thoracic spine, as well as expansion in managing spine tumors, infections, and outpatient surgical cases. There are many rising indications and uses for endoscopic spine surgery in nearly every aspect of the spine. Compared to conventional spine surgery, there is early evidence showing endoscopic surgery is associated with less post-operative pain, shorter hospital stays, and possibly quicker recovery times. As current trends in spine surgery move towards minimally invasive techniques, it is anticipated that the use of endoscopic surgery will continue to expand.

A Robotized Soft Endoscope with Stereo Vision for Upper Gastrointestinal Endoscopic Submucosal Dissection (ESD).

This work presents a novel dual-segment flexible robotic endoscope designed to enhance reachability and dexterity during ESD surgery. The proposed system is capable of executing multi-angle cutting operations at a small angle relative to the lesion surface, allowing for efficient en-bloc resection. Additionally, the system incorporates two calibrated RGB cameras and a depth estimation algorithm to provide detailed 3D information of the tumour, which is used to guide the control framework. A stereo visual servoing controller is also implemented to improve path-following performance during surgery. Experiments results indicate that the proposed system improves motion stability and precision. The root means square error (RMSE) of circle path following is 1.1991mm with a maximum of 1.4751mm. Ex-vivo testing demonstrates its significant potential for use in endoscopic surgery.

Chronic sinusitis diagnosis and treatment

The growing popularity and use of endoscopic surgery in the field of otolaryngology prompts an attempt to organize knowledge about possible methods of surgery in the nasal cavity and paranasal sinuses. Chronic sinusitis is an inflammatory process involving the mucous membrane of the paranasal sinuses, lasting more than 12 weeks. The system of fissures in the lateral wall of the nasal cavity is an ostiomal ductal complex, the obstruction of which is the direct cause of chronic inflammation of the paranasal sinuses. FESS is a modern method in which access to the paranasal sinuses is obtained through the nasal cavity. The aim of the procedure is to widen, above all, too narrow sections of the middle meatus and the orifice-ductal complex. Compared to traditional methods, it is less invasive, allows you to regain the proper function of the maxillary sinus and, moreover, allows you to correct a deviated nasal septum, remove or reduce overgrown turbinates during one operation using the same access. Although traditional methods of surgery are still used in some groups of patients, modern minimally invasive endoscopic surgery strongly limits their use and becomes the method of first choice. Method: The literature was reviewed using the Pub med search engine and Google scholar using the words: Chronic nasal sinusitis, reasons of chronic nasal sinusitis, FESS, acute nasal sinusitis, nasal sinusitis radiology.

Indications and technical aspects of proximal gastrectomy.

According to the World Health Organization, gastric cancer is the fifth most common type of tumor, and is the third most common cause of tumor-associated death. Although gastric cancer incidence rates have decreased in the past few decades, the prevalence of proximal gastric cancer has been steadily rising in developed countries. Techniques regarding the improvement of treatment options must thus be developed. This can be achieved through incorporating both a wider use of endoscopic surgery (endoscopic mucosal resection-EMR, endoscopic submucosal dissection-ESD) and a review of applied surgical interventions. Even though there is no single international consensus available, the Japanese Gastric Cancer Association (JGCA) recommends proximal gastrectomy with D1+ lymphadenectomy in early gastric tumors. Despite recommendations from Asian guidelines and the short term outcomes of the KLASS 05 trial, surgical treatments in Western countries still rely on total gastrectomy. This is mostly due to technical and oncological challenges regarding surgical interventions in a proximal gastrectomy. However, the residual stomach after a proximal gastrectomy has been shown to diminish the incidence of dumping syndrome and anemia, and even improve postoperative quality of life (QoL). Therefore, it is necessary to define the place of proximal gastrectomy in the treatment of gastric cancers.

Trends in surgical procedures for spontaneous intracerebral hemorrhage in Japan

ObjectivesMinimally invasive surgery for spontaneous intracerebral hemorrhage (ICH) has become increasingly popular in recent years. However, there are no reports on the recent trends in surgical procedures for spontaneous ICH. To investigate current trends in surgical methods for spontaneous ICH using a nationwide inpatient database from Japan. Materials and methodsPatients who underwent surgery for spontaneous ICH between April 2014 and March 2018 were identified in a nationwide inpatient database from Japan. We examined patient characteristics, diagnoses, types of surgery, complications, and discharge status. ResultsWe identified 21,129 inpatients who underwent surgery for spontaneous ICH. The procedures were as follows: 16,256 (76.9%) transcranial hemorrhage evacuations, 3722 (17.6%) endoscopic hemorrhage evacuations, and 1151 (5.4%) stereotactic aspirations of hemorrhage. Patients tended to receive transcranial hemorrhage evacuations in hospitals with fewer surgical cases. The proportions of endoscopic hemorrhage evacuations increased annually, whereas those of stereotactic surgery decreased. The proportions of transcranial surgery remained almost unchanged. Tracheostomy and hospitalization costs were lower in the stereotactic aspirations of hemorrhage group, and the proportions of reoperation were higher in the endoscopic hemorrhage evacuations group. ConclusionsThe use of endoscopic surgery for spontaneous ICH has increased in Japan. This study can form the basis of future clinical investigations into spontaneous ICH surgery.

Preoperative prediction of malignant potential of 2-5 cm gastric gastrointestinal stromal tumors by computerized tomography-based radiomics.

BACKGROUNDThe use of endoscopic surgery for treating gastrointestinal stromal tumors (GISTs) between 2 and 5 cm remains controversial considering the potential risk of metastasis and recurrence. Also, surgeons are facing great difficulties and challenges in assessing the malignant potential of 2-5 cm gastric GISTs.AIMTo develop and evaluate computerized tomography (CT)-based radiomics for predicting the malignant potential of primary 2-5 cm gastric GISTs.METHODSA total of 103 patients with pathologically confirmed gastric GISTs between 2 and 5 cm were enrolled. The malignant potential was categorized into low grade and high grade according to postoperative pathology results. Preoperative CT images were reviewed by two radiologists. A radiological model was constructed by CT findings and clinical characteristics using logistic regression. Radiomic features were extracted from preoperative contrast-enhanced CT images in the arterial phase. The XGboost method was used to construct a radiomics model for the prediction of malignant potential. Nomogram was established by combing the radiomics score with CT findings. All of the models were developed in a training group (n = 69) and evaluated in a test group (n = 34).RESULTSThe area under the curve (AUC) value of the radiological, radiomics, and nomogram models was 0.753 (95% confidence interval [CI]: 0.597-0.909), 0.919 (95%CI: 0.828-1.000), and 0.916 (95%CI: 0.801-1.000) in the training group vs 0.642 (95%CI: 0.379-0.870), 0.881 (95%CI: 0.772-0.990), and 0.894 (95%CI: 0.773-1.000) in the test group, respectively. The AUC of the nomogram model was significantly larger than that of the radiological model in both the training group (Z = 2.795, P = 0.0052) and test group (Z = 2.785, P = 0.0054). The decision curve of analysis showed that the nomogram model produced increased benefit across the entire risk threshold range.CONCLUSIONRadiomics may be an effective tool to predict the malignant potential of 2-5 cm gastric GISTs and assist preoperative clinical decision making.

Neurosurgery for brain metastasis from breast cancer.

Breast cancer is the most common malignancy among women worldwide, and the main cause of death in patients with breast cancer is metastasis. Metastasis to the central nervous system occurs in 10% to 16% of patients with metastatic breast cancer, and this rate has increased because of recent advancements in systemic chemotherapy. Because of the various treatments available for brain metastasis, accurate diagnosis and evaluation for treatment are important. Magnetic resonance imaging (MRI) is one of the most reliable preoperative examinations not only for diagnosis of metastatic brain tumors but also for estimation of the molecular characteristics of the tumor based on radiographic information such as the number of lesions, solid or ring enhancement, and cyst formation. Surgical resection continues to play an important role in patients with a limited number of brain metastases and a relatively good performance status. A single brain metastasis is a good indication for surgical treatment followed by radiation therapy to obtain longer survival. Surgical removal is also considered for two or more lesions if neurological symptoms are caused by brain lesions of >3 cm with a mass effect or associated hydrocephalus. Although maximal safe resection with minimal morbidity is ideal in the surgical treatment of brain tumors, supramarginal resection can be achieved in select cases. With respect to the resection technique, en bloc resection is generally recommended to avoid leptomeningeal dissemination induced by piecemeal resection. An operating microscope, neuronavigation, and intraoperative neurophysiological monitoring are essential in modern neurosurgical procedures, including tumor resection. More recently, supporting surgical instruments have been introduced. The use of endoscopic surgery has dramatically increased, especially for intraventricular lesions and in transsphenoidal surgery. An exoscope helps neurosurgeons to comfortably operate regardless of patient positioning or anatomy. A tubular retractor can prevent damage to the surrounding brain tissue during surgery and is a useful instrument in combination with both an endoscope and exoscope. Additionally, 5-aminolevulinic acid (5-ALA) is a promising reagent for photodynamic detection of residual tumor tissue. In the near future, novel treatment options such as high-intensity focused ultrasound (HIFU), laser interstitial thermal therapy (LITT), oncolytic virus therapy, and gene therapy will be introduced.

The role of endoscopic resection for selected patients with sinonasal squamous cell carcinoma

ObjectiveDespite of rapid advances in endoscopic surgery, the gold standard for sinonasal squamous cell carcinoma (SNSCC) surgery has remained the open approach with en-block resection due to the aggressive nature of SNSCC, including frequent recurrence and high mortality rate. For that reason, few studies have focused on SNSCC treated by endoscopic surgery alone. The objective of this study was to evaluate the usefulness of endoscopic surgery for patients with SNSCC. MethodsA retrospective analysis was performed for 15 consecutive SNSCC patients who underwent endoscopic surgery without an open approach. We carefully selected patients whose tumor attachment sites could be fully visualized and completely resected through an endonasal approach. ResultsOf the fifteen patients, 4 patients (27%) were diagnosed with T1, 7 (47%) with T2, 4 (27%) with T3, and no patients with T4a or T4b disease. Four of the 15 (27%) patients showed positive surgical margins. The 5-yr overall survival, disease-specific survival, and local control rate was 72.4%, 79.6%, and 92.9%, respectively. The 5-yr disease-specific survival for T1, T2, and T3 disease was 100% and 75% and 75%, respectively. Patients with negative surgical margins had a better disease-specific survival rate than did those with positive surgical margins (p = 0.0253). ConclusionEndoscopic surgery for patients with SNSCC appears to afford an effective method in selected cases. The achievement of negative surgical margins with a good view of the tumor attachment site was considered to be critical to the management of SNSCC.

Smoke and particulate filters in endoscopic surgery reviewed during COVID-19 pandemic

This study aimed to evaluate the efficacy of smoke filters for use in endoscopic surgery and their significance during the present COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The literature was reviewed by analyzing articles on PubMed using the search terms “smoke”, “filter”, and “laparoscopy”. A systematic literature search revealed six smoke filter clinical studies pertinent to endoscopic surgery. The studies focused on the different aspects and efficacy of these filters: (1) UGF1 filter (Pall Biomedical, St. Germaine en Laye, France) investigated captured mesothelial cells and other debris, (2) Valve-less trocar AirSeal™ (SurgiQuest, Orange, CT) fitted with an ultra-low particulate air (ULPA) filter investigated smoke evacuation and filtration to reduce exposure of staff to hazardous fumes, (3) automatic smoke evacuator (IES2, ERBE) equipped with ULPA identified 37 filtered carcinogenic substances, (4/5) the Tropian trocar (Tropian Tech., Gunpo, Korea), a charcoal filter, investigated in two studies focused on filtration of further hazardous compounds, and (6) charcoal/ULPA combination filter by Dyeing and Finishing Technology Institute investigated filtration rates of volatile organic compounds. Surgical plume can be cleared of hazardous chemical through smoke filters. There were six different filter studies identified with regards to endoscopic surgery which can aid in protecting the surgical staff from dangerous smoke by filtering cells, recirculating, and filtering gas, and removal of carbon-based substances. No clinical study has specifically investigated the removal of viruses by smoke filters including the SARS-CoV-2.

Endoscopic surgery in Japan: The 13th national survey (2014‐2015) by the Japan Society for Endoscopic Surgery

In Japan, the first endoscopic surgery, a laparoscopic cholecystectomy, was performed in 1990. Since then, the operative procedure has been standardized, and the safety and usefulness of endoscopic surgery have been evaluated. In accordance with the social acceptance of endoscopic surgery as a less-invasive surgery, the number of endoscopic procedures has been increasing in all surgical domains. The Japan Society for Endoscopic Surgery (JSES) has played an important role in the development of endoscopic surgery in Japan. For example, JSES established a technical skills certification system for surgeons to train instructors how to teach safe endoscopic surgery, and the organization performs a national survey every 2 years. In 2015, a total of 211 953 patients underwent endoscopic surgery in all surgical domains, including abdominal, thoracic, mammary and thyroid gland, cardiovascular, obstetrics and gynecology, urologic, orthopedic, and plastic surgery. The course of laparoscopic surgery's development and its current status are reported here based on the results of the most recent questionnaire survey conducted by JSES.

Development of a finger like multi-joint articulated surgical retractor for use in endoscopic surgery

The authors have developed an articulated medical instrument which assists with the movement of and maintenance of the position of such as a lung during surgery to assist providing improved viewability and providing the necessary space required to work efficiently and effectively. Conventionally holding such as, a lung in a given position is achieved by arranging gauze in an appropriate configuration with the aid of a simple shaft like surgical instrument, however for various reasons the gauze requires constant replacement and rearrangement resulting in significant surgical inefficiency. By using an articulated mechanism that mimics the functionality of fingers, we have developed a surgical device that inherently provides greater mechanical stability and does not require the use of gauze, thus enabling more efficient surgery. The prototyping process was assisted with the use of 3D-CAD to simulate static and dynamic conditions and a 3D-printer to confirm the concept and then a working prototype was created. In order to validate the dynamic functionality of this surgical instrument, it was tested on a porcine lung which closely approximates human lungs by a clinical doctor of thoracic surgery. The result was that the developed prototype articulated mechanism was able to stably move and hold the lung in position during surgery thus confirming the dynamic efficacy of the mechanism.

Open Approaches to the Anterior Skull Base in Children: Review of the Literature.

Introduction Skull base lesions in children and adolescents are rare, and comprise only 5.6% of all skull base surgery. Anterior skull base lesions dominate, averaging slightly more than 50% of the cases. Until recently, surgery of the anterior skull base was dominated by open procedures and endoscopic skull base surgery was reserved for benign pathologies. Endoscopic skull base surgery is gradually gaining popularity. In spite of that, open skull base surgery is still considered the "gold standard" for the treatment of anterior skull base lesions, and it is the preferred approach in selected cases. Objective This article reviews current concepts and open approaches to the anterior skull base in children in the era of endoscopic surgery. Materials and Methods Comprehensive literature review. Results Extensive intracranial-intradural invasion, extensive orbital invasion, encasement of the optic nerve or the internal carotid artery, lateral supraorbital dural involvement and involvement of the anterior table of the frontal sinus or lateral portion of the frontal sinus precludes endoscopic surgery, and mandates open skull base surgery. The open approaches which are used most frequently for surgical resection of anterior skull base tumors are the transfacial/transmaxillary, subcranial, and subfrontal approaches. Reconstruction of anterior skull base defects is discussed in a separate article in this supplement. Discussion Although endoscopic skull base surgery in children is gaining popularity in developed countries, in many cases open surgery is still required. In addition, in developing countries, which accounts for more than 80% of the world's population, limited access to expensive equipment precludes the use of endoscopic surgery. Several open surgical approaches are still employed to resect anterior skull base lesions in the pediatric population. With this large armamentarium of surgical approaches, tailoring the most suitable approach to a specific lesion in regard to its nature, location, and extent is of utmost importance.

Endoscopic surgery in Japan: The 12th national survey(2012-2013) by the Japan Society for Endoscopic Surgery.

In Japan, the first endoscopic surgery, a laparoscopic cholecystectomy, was performed in 1990. Since then, operative procedures have been standardized, and the safety and usefulness of endoscopic surgery have been evaluated. With the acceptance of endoscopic surgery as less invasive than open surgery, the number of the endoscopic procedures continues to increase in all surgical domains. The Japan Society for Endoscopic Surgery (JSES) has had an important role in the development of endoscopic surgery in Japan. For example, JSES established a technical skills certification system for physicians to train instructors to teach safe endoscopic surgery. Additionally, JSES has performed a national survey every 2 years. In 2013, 178 084 patients underwent endoscopic surgery in all surgical domains, including abdominal, thoracic, mammary and thyroid gland, cardiovascular, obstetrics and gynecology, urologic, orthopedic, and plastic surgery. The development and current status of laparoscopic surgery are reported here based on the results of the most recent questionnaire survey conducted by JSES.

Integrated pressure and temperature sensor with high immunity against external disturbance for flexible endoscope operation

In this study, an integrated pressure and temperature sensor device for a flexible endoscope with long-term stability in in vivo environments was developed and demonstrated. The sensor, which is embedded in the thin wall of the disposable endoscope hood, is intended for use in endoscopic surgery. The device surface is coated with a Cr layer to prevent photoelectronic generation induced by the strong light of the endoscope. The integrated temperature sensor allows compensation for the effect of the temperature drift on a pressure signal. The fabricated device pressure resolution is 0.4 mmHg; the corresponding pressure error is 3.2 mmHg. The packaged device was used in a surgical simulation in an animal experiment. Pressure and temperature monitoring was achieved even in a pH 1 acid solution. The device enables intraluminal pressure and temperature measurements of the stomach, which facilitate the maintenance of internal stomach conditions. The applicability of the sensor was successfully demonstrated in animal experiments.

Advances in endoscopic surgery for small animal reproduction.

Although endoscopic surgery entered its "golden era" in the mid-1980s, it is still advancing at a tremendous pace. Novel surgical techniques and devices are continuously developed and applied, and new indications (and/or contraindications) for the use of endoscopic surgery are routinely reported in the literature and subjected to systematic assessments. Although endoscopic surgery (laparoscopy in particular) has already become established as the gold standard in human medicine, it has yet to be proven as a viable alternative to open surgery in the field of veterinary medicine. The advantages of minimally invasive surgery include better intra-operative visualization, reduced postoperative pain, reduced scar formation and increased postoperative mobility. Therefore, it is reasonable to expect that the application of this will continue to expand. Small animal reproduction, a field within the broad discipline of veterinary medicine, has already recognized and begun to reap the benefits of endoscopic surgery. Herein, we retrospectively review the most recent successful novel applications of endoscopic surgery in the small animal reproduction system to provide small animal reproductive surgeons with important knowledge to help improve their own veterinarian medical practice.

Tratamiento endoscópico de la patología tendinosa alrededor de la cadera: psoas, glúteo medio e isquiotibiales

ObjectivesTo present the new therapeutic options currently offered by endoscopic surgery in order to resolve tendon pathology around the hip joint, in the so-called ‘outside the box surgery’. MethodsA review of the literature and the authors’ experience is presented on the use of endoscopic surgery in resolving tendon pathology around the hip joint. ResultsAlthough there are still no large published series, there already appears to be sufficient evidence that endoscopic surgery offers at least similar results to those of open surgery for the treatment of this pathology, as well as having lower morbidity and complication rates. ConclusionsFor those surgeons treating hip pathology, mastering arthro-endoscopic surgical techniques is extremely useful in order to resolve problems that would require complex or deep approaches using open surgery. Level of evidence5 Clinical relevanceKnowledge of arthro-endoscopic therapeutic possibilities will help surgeons to choose the best surgical option for patients.

Usefulness of endoscopic surgery for traumatic intracranial hemorrhage

Usefulness of endoscopic surgery for traumatic intracranial hemorrhage

Nationwide shift from microscopic to endoscopic transsphenoidal pituitary surgery.

Transsphenoidal pituitary surgery can be carried out with either an operating microscope or with an endoscope, but the relative frequency of both techniques is unknown. All microscopic and endoscopic transsphenoidal pituitary surgeries were extracted from the Centers for Medicare and Medicaid Services Part B data files between the years 2003 and 2013. National and state-level trends were compared over time. Endoscopic surgery significantly increased and microscopic surgery significantly decreased over the years 2003-2013. Thirty-eight of 48 states increased their use of endoscopic surgery, while 38 of 48 states decreased their use of microscopic surgery. Nationwide data show a clear trend for an increasing use of endoscopic transsphenoidal surgery at the expense of microscopic surgery. The underlying causes of these trends are unknown, but clearly deserve further investigation.

An augmented reality navigation system for pediatric oncologic surgery based on preoperative CT and MRI images

PurposeIn pediatric endoscopic surgery, a limited view and lack of tactile sensation restrict the surgeon's abilities. Moreover, in pediatric oncology, it is sometimes difficult to detect and resect tumors due to the adhesion and degeneration of tumors treated with multimodality therapies. We developed an augmented reality (AR) navigation system based on preoperative CT and MRI imaging for use in endoscopic surgery for pediatric tumors. MethodsThe patients preoperatively underwent either CT or MRI with body surface markers. We used an optical tracking system to register the reconstructed 3D images obtained from the CT and MRI data and body surface markers during surgery. AR visualization was superimposed with the 3D images projected onto captured live images. Six patients underwent surgery using this system. ResultsThe median age of the patients was 3.5years. Two of the six patients underwent laparoscopic surgery, two patients underwent thoracoscopic surgery, and two patients underwent laparotomy using this system. The indications for surgery were local recurrence of a Wilms tumor in one case, metastasis of rhabdomyosarcoma in one case, undifferentiated sarcoma in one case, bronchogenic cysts in two cases, and hepatoblastoma in one case. The average tumor size was 22.0±14.2mm. Four patients were treated with chemotherapy, three patients were treated with radiotherapy before surgery, and four patients underwent reoperation. All six tumors were detected using the AR navigation system and successfully resected without any complications. ConclusionsThe AR navigation system is very useful for detecting the tumor location during pediatric surgery, especially for endoscopic surgery.

Endoscopic surgery combined with sacculus-assisted cerebrum corridor creator for hypertensive basal ganglia cerebral hemorrhage

Objective To evaluate the use of endoscopic surgery conbined with sacculus-assisted cerebrum corridor creator for hypertensive basal ganglia cerebral hemorrhage.Methods Twenty patients with hyertensive intracerebral hematoma were evacuated with neuroendoscope combined with sacculus-assisted cerebrum corridor creator.The hematoma evacuation rate,rebleeding rate,mortality rate and GOS score were recorded.Results Complete evacuation of hematoma was achieved in 10 patients,and partial evacuation in 10.The hematoma evacuation rate was 93％.The rebleeding rate is 0.The mortality rate was 5％.According to GOS score at 6-month follow-up,the result was V in 9 patients,Ⅳ-in 6,Ⅲ in 3,Ⅱ and Ⅰ in one respectively.Conclusion Neuroendoscopic surgery for hypertensive intracerebral hematoma is characterized by safety,mininvasion,visuality,good hemostasis,good hematoma evacuation,and is a new way in hypertensive cerebral hemorrhage. Key words: Hypertensive intracerebral hemorrhage; Neuroendoscope ; Sacculus ; Cerebrum corridor creator