TY - JOUR
T1 - Endoscope Holders in Cranial Neurosurgery
T2 - Part 2—An International Survey
AU - Paraskevopoulos, Dimitrios
AU - Constantini, Shlomi
AU - Bal, Jarnail
AU - Roth, Jonathan
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2018/3
Y1 - 2018/3
N2 - Background: Following a previous systematic review of currently available endoscope holders (EHs), 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. The questionnaire evaluated indications and pitfalls of EH in different applications, in particular, differentiating between intraventricular and skull base endoscopy, as well as subcategories of these 2 main fields. Furthermore, interest or involvement in research projects on EH was investigated. Results: Fifty-two surgeons responded, with a broad geographic distribution represented. Most (54%) do not routinely use EH. Others use 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. Conclusions: 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.
AB - Background: Following a previous systematic review of currently available endoscope holders (EHs), 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. The questionnaire evaluated indications and pitfalls of EH in different applications, in particular, differentiating between intraventricular and skull base endoscopy, as well as subcategories of these 2 main fields. Furthermore, interest or involvement in research projects on EH was investigated. Results: Fifty-two surgeons responded, with a broad geographic distribution represented. Most (54%) do not routinely use EH. Others use 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. Conclusions: 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.
KW - Endoscope
KW - Endoscopic-assisted
KW - Holding device
KW - Minimally invasive surgery
KW - Neuroendoscopy
KW - Neurosurgery
KW - Skull base
KW - Ventricular surgery
UR - http://www.scopus.com/inward/record.url?scp=85041583831&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2017.12.142
DO - 10.1016/j.wneu.2017.12.142
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C2 - 29305118
AN - SCOPUS:85041583831
SN - 1878-8750
VL - 111
SP - e632-e643
JO - World Neurosurgery
JF - World Neurosurgery
ER -