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一种用于颅内观察的新型超细柔性神经内窥镜的研发。

The development of a new, ultra-fine, and flexible neuroendoscope for intracranial observation.

作者信息

Onoda Keisuke, Sashida Ryohei, Hirokawa Yu, Fujiwara Ren, Wakamiya Tomihiro, Michiwaki Yuhei, Tanaka Tatsuya, Shimoji Kazuaki, Suehiro Eiichi, Yamane Fumitaka, Kawashima Masatou, Matsuno Akira

机构信息

Department of Neurosurgery, International University of Health and Welfare, Narita City, Japan.

出版信息

Surg Neurol Int. 2022 Oct 7;13:460. doi: 10.25259/SNI_748_2022. eCollection 2022.

Abstract

BACKGROUND

A neuroendoscope is a technical advance that allows surgeons to visualize certain regions of the brain that was previously inaccessible through the use of a surgical microscope. Several neuroendoscope designs have been implemented by other neurosurgeons over the past 5 years. The advantage of a neuroendoscope is the addition of a flexible and narrow tip that allows for safe entry into intracranial structures for clinical observation. However, there are some limitations to this approach. Here, we report the use of a modified angioscope as a newly developed neuroendoscope to be employed in observing intracranial structures.

METHODS

We report the use of an angioscope that is 1.8 mm in diameter and has both a thin and flexible tip. In this study, the angioscope was inserted into the lumen of an aspirator tube, and the tip of the device was placed at the intracranial area of intended observation area. Image findings were evaluated using an established goat brain model.

RESULTS

The angioscope was light in weight and maneuverable and could be reached and observed in the blind spot using a surgical microscope. From the cerebellopontine angle, the lower cranial nerves and trigeminal nerve could be observed, and from the cisterna magna, the floor of the fourth ventricle and the aqueduct could be seen.

CONCLUSION

The angioscope is a useful instrument to observe intracranial locations safely and effectively even within a limited surgical field. Further modifications will be required to use the angioscope in various craniotomy procedures.

摘要

背景

神经内窥镜是一项技术进步,使外科医生能够可视化大脑中某些以前通过手术显微镜无法触及的区域。在过去5年中,其他神经外科医生已经采用了几种神经内窥镜设计。神经内窥镜的优点是增加了一个灵活且狭窄的尖端,可安全进入颅内结构进行临床观察。然而,这种方法存在一些局限性。在此,我们报告使用一种改良的血管内窥镜作为新开发的神经内窥镜来观察颅内结构。

方法

我们报告使用一种直径为1.8毫米、尖端细且灵活的血管内窥镜。在本研究中,将血管内窥镜插入吸引管腔内,并将该设备的尖端置于预期观察区域的颅内区域。使用已建立的山羊脑模型评估图像结果。

结果

该血管内窥镜重量轻且可操作,使用手术显微镜可在盲点处触及并观察到。从小脑桥脑角可观察到低位颅神经和三叉神经,从枕大池可看到第四脑室底部和导水管。

结论

血管内窥镜是一种即使在有限的手术视野内也能安全有效地观察颅内位置的有用器械。在各种开颅手术中使用血管内窥镜还需要进一步改进。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d724/9609956/889ed7c93ed7/SNI-13-460-g001.jpg

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