title: Optimal invasive key-hole neurosurgery with a miniaturized 3D chip on the tip: Microendoscopic device.
abstract: OBJECTIVE
  The goal of the performed study was to evaluate the possibility of a three-dimensional endoscope to become a combined microscope-endoscope device in one. We analyzed the ergonomy of the device, the implementation into the surgical workflow, the image quality, and the future perspectives such devices could have for the next generation of neurosurgeons.
  
  
  METHODS
  Within 6 months, 22 patients (10 male, 12 female, 20-65 age) underwent surgery in neuroaxis using the new 3D-microendoscope (ME). The new 3D-ME has (a) the ability to visualize the surgical field from out- to inside with all advantages offered by a microscope, and in the same moment, (b) its design is like a small diameter endoscope that allows stereoscopic views extracorporal, intracorporal, and panoramic "para-side" of the lesion.
  
  
  RESULTS
  In general, transcranial 3D-"microendoscopy" was performed in all patients with high-resolution 3D quality. No severe complications were observed intra- or postoperatively. With the addition of depth perception, the anatomic structures were well seen and observed.
  
  
  CONCLUSIONS
  The 3D-microendoscopy is a very promising surgical concept associated with new technological developments. The surgeon is able to switch to a modern visualization instrument reaching the most optimal surgical approach without compromising safety, effectiveness, and visual information.
authors.affiliation: Department of Neurosurgery, Hospital Merheim, University of Witten-Herdecke, Cologne, Germany.
authors.forename: Patra
authors.initials: P
authors.lastname: Charalampaki
authors.affiliation: Department of Neurosurgery, Hospital Merheim, University of Witten-Herdecke, Cologne, Germany.
authors.forename: Alhadi
authors.initials: A
authors.lastname: Igressa
authors.affiliation: Department of Neurosurgery, Hospital Merheim, University of Witten-Herdecke, Cologne, Germany.
authors.forename: Mehran
authors.initials: M
authors.lastname: Mahvash
authors.affiliation: Department of Neurosurgery, Hospital Merheim, University of Witten-Herdecke, Cologne, Germany.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Pechlivanis
authors.affiliation: Department of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schick
keywords: Endoscopy; microendoscopy; skull base surgery; three dimensionality