Advertisement

Acta Neurochirurgica

, Volume 134, Issue 3–4, pp 190–195 | Cite as

Endoscopically assisted microneurosurgery

  • C. Matula
  • M. Tschabitscher
  • J. Diaz Day
  • A. Reinprecht
  • W. T. Koos
Article

Summary

Technological developments in neuroendoscopy are leading to an expansion of applications into the realm of microneurosurgical procedures. The new dimension that using an endoscope provides requires insight into different neuroanatomical aspects and a new kind of strategy in planning a microneurosurgical procedure. To gain some new insights into these exciting aspects of neurosurgery we have explored the sellar, parasellar, and posterior fossa regions in 50 fresh anatomical specimens and used various types of endoscopes to observe the surgically relevant neurotopographical details. We then utilized this experience in 33 clinical cases during microsurgical approaches for various lesions (posterior fossa tumors — 12 cases, sellar and parasellar tumors — 8 cases, transsphenoidal procedures for pituitary adenoma — 7 cases, transventricular procedures — 6 cases). In the laboratory we found that familiar neuroanatomical structures are seen in a completely different aspect from what we are accustomed. Orientation is at times difficult, which requires rehearsal and special handling of the endoscope for complex clinical procedures. We found that certain structures that are hardly noticed in routine anatomical views become very important when utilizing the endoscope (i.e., different arachnoid membranes and trabeculae). Importantly, the dimensions of a microsurgical approach can be greatly enlarged with the endoscope, making it possible to look behind structures and “around corners”. We present our findings with respect to important anatomical details relevant to utilizing the endoscope as an adjunct to microneurosurgical procedures and our clinical data. We have concluded that the neuroendoscope can be a safe and helpful adjunct in many microneurosurgical procedures.

Keywords

Neuroendoscopy microsurgery neuroanatomy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Auer LM, Holzer P, Ascher PW, Heppner F (1988) Endoscopic neurosurgery. Acta Neurochir (Wien) 90: 1–14Google Scholar
  2. 2.
    Bauer BL, Hellwig D (eds) Minimal invasive neurosurgery I. Acta Neurochir (Wien) [Suppl]: 54Google Scholar
  3. 3.
    Dandy WE (1922) Cerebral ventriculoscopy. Johns Hopkins Hosp Bull 33: 189Google Scholar
  4. 4.
    Fukushima T (1978) Endoscopy of Meckel's cave, cisterna magna, and cerebellopontine angle. J Neurosurg 48: 302–306PubMedGoogle Scholar
  5. 5.
    Fukushima T (1977) Ventriculofiberscope: a new technique for endoscopie diagnosis and operation. J Neurosurg 38: 251–256Google Scholar
  6. 6.
    Grifith HB (1986) Endoneurosurgery: endoscopic intracranial surgery. In: Simon L,et al. (eds) Advances and technical standards in neurosurgery, Vol 14. Springer, Wien New York, pp 2–24Google Scholar
  7. 7.
    L'Espinasse VL: In: Davis E (ed) Neurological surgery, 2nd Ed. Lea and Febinger, Philadelphia, 442 ppGoogle Scholar
  8. 8.
    Manwaring KH, Crone KR (eds) (1992) Neuroendoscopy, Vol 1. Liebert, New YorkGoogle Scholar
  9. 9.
    Matula C, Tschabitscher M, Kitz K, Reinprecht A, Koos WT (1995) Neuroanatomical details under endoscopical view. Relevant for neurosurgery? Acta Neurochir (Wien) [Suppl] 63: 1–4Google Scholar
  10. 10.
    Perneczky A, Tschabitscher M, Resch K (1993) Atlas of endoscopic anatomy for neurosurgery. Thieme, StuttgartGoogle Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • C. Matula
    • 1
  • M. Tschabitscher
    • 2
  • J. Diaz Day
    • 3
  • A. Reinprecht
    • 1
  • W. T. Koos
    • 1
  1. 1.Department of NeurosurgeryUniversity of ViennaViennaAustria
  2. 2.Department of AnatomyUniversity of ViennaViennaAustria
  3. 3.Department of NeurosurgeryUniversity of Southern CaliforniaLos AngelesUSA

Personalised recommendations