Ebner Florian H, Hirt Bernhard, Marquardt Jakob S, Herlan Stephan, Tatagiba Marcos, Schuhmann Martin U
Department of Neurosurgery, Eberhard-Karls-University, Tübingen, Germany.
Childs Nerv Syst. 2012 Jan;28(1):87-91. doi: 10.1007/s00381-011-1537-3. Epub 2011 Aug 18.
We assessed usability and applicability of a rigid, multidirectional steerable videoendoscope (EndActive, Karl Storz GmbH, Tuttlingen, Germany) for endoscopic third ventriculostomy and compared our experience with reports about other multidirectional endoscopes.
The prototype is a 4-mm-diameter rigid videoendoscope with an integrated image sensor comprising an embedded light source, offering a free viewing direction in a range of 160° while the tip itself does not move. In five specimens (ten sides), we introduced the endoscope via precoronal burr holes through the lateral ventricle and foramen of Monro into the third ventricle. The endoscope's tip was positioned at the level of the mamillary bodies and the previously defined anatomical target structures; anteriorly, the optic chiasm, anterior commissure, infundibulum, tuber cinereum and posteriorly, the entrance to the mesencephalic aqueduct and posterior commissure were inspected.
A single insertion of the videoendoscope was sufficient to explore with the multiplanar viewing mechanism the entire third ventricle. The prototype videoendoscope may be held like a microsurgical instrument in one hand. It is feasible to control movements precisely due to the reduced weight and ergonomic shape of the device.
The prototype EndActive has the potential to fit in the current concept of ETV and enrich the setting adding working economy and viewing variability.
我们评估了一种刚性、多向可操纵视频内镜（EndActive，卡尔史托斯有限公司，德国图特林根）在内镜下第三脑室造瘘术中的可用性和适用性，并将我们的经验与其他多向内镜的报道进行了比较。
该原型是一种直径4毫米的刚性视频内镜，带有集成图像传感器，包括嵌入式光源，在尖端本身不移动的情况下可提供160°范围内的自由观察方向。在五个标本（十个侧面）中，我们通过冠状前钻孔将内镜经侧脑室和室间孔引入第三脑室。内镜尖端定位在乳头体水平和先前定义的解剖目标结构处；向前检查视交叉、前连合、漏斗、灰结节，向后检查中脑导水管入口和后连合。
视频内镜单次插入就足以通过多平面观察机制探索整个第三脑室。原型视频内镜可以像显微手术器械一样单手握持。由于设备重量减轻和人体工程学形状，精确控制运动是可行的。
原型EndActive有潜力符合当前ETV的概念，并通过增加工作经济性和观察可变性来丰富该术式。
