Endoscope holders in Cranial Neurosurgery: Part 2 - An international survey.

Endoscope holders in Cranial Neurosurgery: Part 2 - An international survey.

World Neurosurg. 2018 Jan 02;:

Authors: Paraskevopoulos D, Constantini S, Bal J, Roth J

Abstract
BACKGROUND: Following a prior systematic review of currently available endoscope holders (EH), we aspired to detect trends, task-specific preferences and pitfalls of EH in various cranial neuroendoscopic procedures.
METHODS: A questionnaire was disseminated to members of the International Federation of Neuroendoscopy (IFNE). The questionnaire evaluated indications and pitfalls of EH in different applications, in particular, differentiating between intraventricular and skull base endoscopy, as well as sub-categories of these two main fields. Furthermore, interest or involvement in research projects on EH was investigated.
RESULTS: Fifty two surgeons responded, with a broad geographic distribution. Most (54%) do not routinely use EH. Others utilize holders mainly for intraventricular rather than skull base procedures. Most surgeons (96%) regularly work with a co-surgeon. Reported weaknesses of EH included crude movements, downward drift, loss of depth perception, lack of flexibility, iatrogenic injury, cost and bulky construct. There is still a lack of consensus on surgical indications. Tumor resections in intraventricular and skull base regions (not small sellar tumors) seem to stand out as good, widely accepted indications.
CONCLUSION: Although EH have a role in cranial neuroendoscopy, their use seems limited and their technical features are regarded as suboptimal by most neuroendoscopists. Weaknesses and implications were detected in all application categories (skull base and intraventricular), but may vary slightly. Potentially, separate systems with distinct features may be required for skull base versus intraventricular surgery. There is a need for further evolution of EH, which could lead to a future paradigm shift in their use.

PMID: 29305118 [PubMed - as supplied by publisher]

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