Endoscope holders in Cranial Neurosurgery: Part I - technology, trends and implications.

Endoscope holders in Cranial Neurosurgery: Part I - technology, trends and implications.

World Neurosurg. 2016 Feb 1;

Authors: Paraskevopoulos D, Roth J, Constantini S

Abstract
OBJECTIVE: Cranial neuroendoscopy is becoming increasingly popular. Endoscopes may be used freehand or with endoscope holders (EH). Aim of this paper is to summarize the evolution of EH and attempt an overview of currently available devices, features and usage, identifying weaknesses and focusing on feasibility.
METHODS: A systematic review was conducted on Pubmed, OvidSP, EBSCO and Google Scholar. Targeted search through cross-references was also implemented, followed by personal contacts, interviews, company websites and operating manuals. A pilot survey was performed to acquire an impression on current state of usage. This was conducted by approaching surgeons from several countries, via email and online through a neurosurgical exchange forum. A more extensive survey will follow as Part II.
RESULTS: EH may be devided into manual and pneumatic. The use of micromanipulators is sometimes implemented. Different characteristics have been described, such as pneumatic, mechanical, friction, micromanipulator, robotic, hybrid, air-locking, voice-control. Twenty eight surgeons responded. The majority (75%) do not routinely use EH. The rest utilize holders mainly for intraventricular rather than skull base procedures. Nearly all surgeons (96%) stated using a second surgeon regularly. Reported weaknesses included crude movements, downward drift, loss of depth perception, lack of flexibility, iatrogenic injury, cost, bulky construct.
CONCLUSION: Although EH have a role in Neuroendoscopy, their use seems limited and their features are regarded as suboptimal. There are no clear indications regarding the procedures that should be performed using EH. Many factors affect the implication of EH, including safety, type of surgery, surgeon's preference and mechanical properties.

PMID: 26844875 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1QhnbwQ
via IFTTT