Man-to-Machine Interface in Neuroendoscopy: The Importance of Human Interface in the Development of Neuroendoscopy

Abstract

Endoscopy was first employed in the surgical treatment of neurosurgical diseases early in the twentieth century but did not become an established practice for a long time, mainly because of poor technology and clinical results. We could call the first two decades of the twentieth century the invention phase. After decades of neglect, a kind of ‘dark ages’, neuroendoscopy is enjoying a sustained resurgence. After a slow timid reappearance in the 1980s, the 1990s saw an explosion of techniques and instrumentation. We could call the 1980s the reinvention phase and the 1990s the expansion phase. After an early phase of enthusiasm, which lasted several years, now we are entering a phase of consolidation. We have crystallised indications and mapped out success. Further expansion will follow a mature course.

The history of neuroendoscopy is paralleled by the evolution of neuroendoscope design. Despite the technological advances in other fields of medical technology and the wide use of computer and robotic technology, the basic design of neuroendoscopes dates back to the early days of cystoscopes of the early twentieth century, has not changed much in the last three decades and in many aspects is ergonomically disadvantageous. The main progress has been in the digital camera that is coupled to the rod lens. A variety of surgical instruments have been designed for the endoscopes, which contributed to improved surgical outcomes.

A critical review of the endoscope design shortcomings will be presented, and possible means to overcome them will be discussed.