1Division of Neurosurgery, Hospital das Clínicas of University of São Paulo Medical School; and.
2Hospital Israelita Albert Einstein, São Paulo, Brazil.
J Neurosurg. 2019 Jan 1;130(1):90-98. doi: 10.3171/2017.6.JNS1712. Epub 2018 Mar 13.
Advances in video and fiber optics since the 1990s have led to the development of several commercially available high-definition neuroendoscopes. This technological improvement, however, has been surpassed by the smartphone revolution. With the increasing integration of smartphone technology into medical care, the introduction of these high-quality computerized communication devices with built-in digital cameras offers new possibilities in neuroendoscopy. The aim of this study was to investigate the usefulness of smartphone-endoscope integration in performing different types of minimally invasive neurosurgery.
The authors present a new surgical tool that integrates a smartphone with an endoscope by use of a specially designed adapter, thus eliminating the need for the video system customarily used for endoscopy. The authors used this novel combined system to perform minimally invasive surgery on patients with various neuropathological disorders, including cavernomas, cerebral aneurysms, hydrocephalus, subdural hematomas, contusional hematomas, and spontaneous intracerebral hematomas.
The new endoscopic system featuring smartphone-endoscope integration was used by the authors in the minimally invasive surgical treatment of 42 patients. All procedures were successfully performed, and no complications related to the use of the new method were observed. The quality of the images obtained with the smartphone was high enough to provide adequate information to the neurosurgeons, as smartphone cameras can record images in high definition or 4K resolution. Moreover, because the smartphone screen moves along with the endoscope, surgical mobility was enhanced with the use of this method, facilitating more intuitive use. In fact, this increased mobility was identified as the greatest benefit of the use of the smartphone-endoscope system compared with the use of the neuroendoscope with the standard video set.
Minimally invasive approaches are the new frontier in neurosurgery, and technological innovation and integration are crucial to ongoing progress in the application of these techniques. The use of smartphones with endoscopes is a safe and efficient new method of performing endoscope-assisted neurosurgery that may increase surgeon mobility and reduce equipment costs.
自 20 世纪 90 年代以来，视频和光纤技术的进步促使几种商业上可用的高清神经内镜得以发展。然而，这一技术进步已经被智能手机革命所超越。随着智能手机技术在医疗保健中的日益融合，内置数字摄像头的这些高质量计算机化通信设备的引入为神经内镜提供了新的可能性。本研究旨在探讨智能手机内镜集成在执行不同类型的微创神经外科手术中的有用性。
作者介绍了一种新的手术工具，该工具通过使用专门设计的适配器将智能手机与内镜集成在一起，从而消除了通常用于内镜的视频系统的需求。作者使用这种新颖的联合系统对患有各种神经病理疾病的患者进行了微创手术，包括海绵状血管瘤、脑动脉瘤、脑积水、硬膜下血肿、脑挫裂伤血肿和自发性脑内血肿。
作者使用新型内镜系统对 42 名患者进行了微创外科治疗。所有手术均成功完成，未观察到与使用新方法相关的并发症。使用智能手机获得的图像质量足够高，可以向神经外科医生提供足够的信息，因为智能手机摄像头可以以高清或 4K 分辨率记录图像。此外，由于智能手机屏幕随内镜移动，因此使用该方法提高了手术的灵活性，从而使操作更加直观。实际上，与使用带有标准视频套件的神经内镜相比，智能手机内镜系统的使用提高了机动性，被认为是使用该系统的最大优势。
微创方法是神经外科的新前沿，技术创新和集成对于这些技术的应用的持续进展至关重要。使用带有内镜的智能手机是一种安全有效的新方法，可进行内镜辅助神经外科手术，从而提高外科医生的机动性并降低设备成本。
