Minim Invasive Neurosurg 2006; 49(6): 380-383
DOI: 10.1055/s-2006-958728
Technical Note

© Georg Thieme Verlag KG · Stuttgart · New York

Microfiberscope Coaxial Technique in Neuroendoscopic Surgery

Y. Arakawa 1 , 2 , K. Nakazawa1 , H. Kataoka 1 , K. Kikuta 1 , N. Hashimoto 1
  • 1Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
  • 2Cancer Research UK, London Research Institute, London, UK
Further Information

Publication History

Publication Date:
23 February 2007 (online)

Abstract

Exploration in neuroendoscopic surgery is occasionally insufficient because of the structural limitations in endoscope. It is not easy to identify the precise position of the endoscope during an operation. We here show a coaxial technique for neuroendoscopic exploration with monitoring by means of a microfiberscope. The endoscopic coaxial technique consists of two scopes. The microfiberscope has a diameter of 0.75 mm, flexible body and high-quality image system. We tested its ability to visualize the subject at several distances and applied this coaxial technique in neuroendoscopic surgery. The microfiberscope not only visualizes the object but also magnifies it by a distance. The scope was easy to handle with monitoring of its movement in the endoscopic view. The technique allowed us to safely explore details which are difficult to approach with an ordinary fiberscope or rigid-rod scope. The microfiberscope also adjusts to the neuronal anatomy and many clinical situations. Taken together, the microfiber coaxial technique might offer new advantages to modern neuroendoscopic surgery.

References

  • 1 Apuzzo ML, Heifetz MD, Weiss MH, Kurze T. Neurosurgical endoscopy using the side-viewing telescope.  J Neurosurg. 1977;  46 398-400
  • 2 Buxton N, Ho KJ, Macarthur D, Vloeberghs M, Punt J, Robertson I. Neuroendoscopic third ventriculostomy for hydrocephalus in adults: report of a single unit's experience with 63 cases.  Surg Neurol. 2001;  55 74-78
  • 3 Cappabianca P, de Divitiis E. Endoscopy and transsphenoidal surgery.  Neurosurgery. 2004;  54 1043-1048
  • 4 Hellwig D, Kuhn TJ, Bauer BL, List-Hellwig E. Endoscopic treatment of septated chronic subdural hematoma.  Surg Neurol. 1996;  45 272-277
  • 5 Cohen AR. Ventriculoscopic surgery.  Clin Neurosurg. 1994;  41 546-562
  • 6 Fukushima T, Ishijima B, Hirakawa K, Nakamura N, Sano K. Ventriculofiberscope: a new technique for endoscopic diagnosis and operation. Technical note.  J Neurosurg. 1973;  38 251-256
  • 7 Gerzeny M, Cohen AR. Advances in endoscopic neurosurgery.  AORN J. 1998;  67 957-961 963-965
  • 8 Hellwig D, Grotenhuis JA, Tirakotai W, Riegel T, Schulte DM, Bauer BL, Bertalanffy H. Endoscopic third ventriculostomy for obstructive hydrocephalus.  Neurosurg Rev. 2005;  28 1-34
  • 9 Iantosca MR, Hader WI, Drake JM. Results of endoscopic third ventriculostomy.  Neurosurg Clin N Am. 2004;  15 67-75
  • 10 Schroeder HW, Warzok RW, Assaf JA, Gaab MR. Fatal subarachnoid hemorrhage after endoscopic third ventriculostomy. Case report.  J Neurosurg. 1999;  90 153-155
  • 11 Arya N, Nelles SE, Haber GB, Kim YI, Kortan PK. Electrohydraulic lithotripsy in 111 patients: a safe and effective therapy for difficult bile duct stones.  Am J Gastroenterol. 2004;  99 2330-2334
  • 12 Robinson S, Cohen AR. The role of neuroendoscopy in the treatment of pineal region tumors.  Surg Neurol. 1997;  48 360-365
  • 13 Cappabianca P, Buonamassa S, Cavallo LM, Mariniello G, de Divitiis O. Neuroendoscopy: present and future applications.  Clin Neurosurg. 2004;  51 186-190
  • 14 Schroeder HW, Wagner W, Tschiltschke W, Gaab MR. Frameless neuronavigation in intracranial endoscopic neurosurgery.  J Neurosurg. 2001;  94 72-79
  • 15 Sure U, Hellwig D, Bertalanffy H. Incorrect vector after calibration of surgical instruments for image guidance. The problem and the solution: technical note.  Minim Invas Neurosurg. 2001;  44 88-91
  • 16 Tirakotai W, Bozinov O, Sure U, Riegel T, Bertalanffy H, Hellwig D. The evolution of stereotactic guidance in neuroendoscopy.  Childs Nerv Syst. 2004;  20 790-795
  • 17 Levy ML, Day JD, Albuquerque F, Schumaker G, Giannotta SL, McComb JG. Heads-up intraoperative endoscopic imaging: a prospective evaluation of techniques and limitations.  Neurosurgery. 1997;  40 526-530

Correspondence

Yoshiki ArakawaM.D., Ph.D 

Cancer Research UK·London Research Institute

44 Lincoln's Inn Fields

London WC2A 3PX

UK

Phone: +44/20/72 69 37 35

Fax: +44/20/72 69 35 81

Email: yarakawa@sb3.so-netne.ip

    >