Efficacy of a navigation system in neuro-endoscopic surgery.
OBJECTIVE
Neuro-endoscopy is playing a greater role in the diagnosis and treatment of several types of lesions, especially in the ventricular system. However, surgical planning and intraoperative orientation during endoscopic surgery are sometimes difficult. The efficacy of a neurosurgical navigation system using three-dimensional computer graphics of magnetic resonance (MR) images in neuro-endoscopic surgery was evaluated in this study.


METHODS
We have developed a navigational endoscopic system designed to monitor the tip and direction of the endoscope, with the mirror marker of the navigation connected to a rigid endoscope. Eight patients, 3 cases of aqueductal stenting for isolated fourth ventricle, 3 cases of cystostomy for ependymal cyst, 1 case of septostomy for isolated lateral ventricle, and 1 case of ventricular tap in narrow ventricles, underwent endoscopic surgery using the present system.


RESULTS
All patients underwent successful procedures with good outcomes. The present system was very useful in the cases of an accurate ventricular tap in narrow ventricles, identification of anatomic structures, and determining the appropriate route to the target point.


CONCLUSIONS
This navigational endoscopic system improved the safety and accuracy of neuro-endoscopic surgery.
Hamada
H
H
Department of Neurosurgery, Toyama Medical and Pharmaceutical University, Toyama, Japan.
Hayashi
N
N
Asahi
T
T
Kurimoto
M
M
Hirashima
Y
Y
Endo
S
S
D000293:Adolescent; D000328:Adult; D001927:Brain Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000295:instrumentation*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation*; D019635:Neurosurgical Procedures / Q000379:methods*; D012507:Sarcoidosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome