title: Preliminary Experience with a New Multidirectional Videoendoscope for Neuroendoscopic Surgical Procedures.
abstract: OBJECTIVE
  We assessed the applicability of a new multidirectional videoendoscope (digiCAMeleon, Karl Storz GmbH, Tuttlingen, Germany) in various neuroendoscopic procedures.
  
  
  METHODS
  A 4-mm-diameter rigid videoendoscope (digiCAMeleon, Karl Storz GmbH, Tuttlingen, Germany) with 1 sensor and an internal LED light source was tested. The device offers a resolution of 1920 x 1080 pixels and weighs ≈ 215 g. The prototype was tested on three cadaveric heads using three different approaches: a) endoscopic endonasal transsphenoidal; b) frontal transcortical intraventricular; c) supraorbital.
  
  
  RESULTS
  We identified several major benefits of the integrated system as applied to endoscopic endonasal, transcortical intraventricular, and endoscopic supraorbital keyhole approaches. These included improved maneuverability of the scope on account of reduced bulk and integration of the camera and fiberoptic light components, a variable angle of view from 0-70 degrees, and a novel feature that can be activated to maintain orientation of the surgical horizon. Our preliminary report highlights the potential for handling the videoendoscope in one hand, as one would a microsurgical instrument. The videoendoscope harbors all its electronic and lighting data into a unique and thin cable, thus resembling a modern "all-in-one" computer technology. Because of its reduced weight and ergonomic shape, controlling its movements is very easy and comfortable, even in the microsurgical environment. Furthermore, the videoendoscope offers the unique feature of orienting the horizon of vision, thanks to the possibility of offering angled views while working; this helps the surgeons to stay oriented with direct visualization and improved control of the instruments over a specific area of interest.
  
  
  CONCLUSIONS
  The videoendoscope prototype represents an HD-image quality versatile tool in a neurosurgical environment, thanks to its reduced weight and dimensions; in these preliminary simulations, we have identified optimized visibility and maneuverability as major benefits of this novel surgical adjunct.
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Cavallo
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Di Somma
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Solari
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Oreste
authors.initials: O
authors.lastname: de Divitiis
authors.affiliation: Department of Public Health, Unit of Vascular and Endovascular Surgery, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Umberto Marcello
authors.initials: UM
authors.lastname: Bracale
authors.affiliation: Department of Neurosciences, Reproductive and Odontostomatological Sciences, Division of Neurosurgery, Università degli Studi di Napoli "Federico II", Naples, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cappabianca
mesh_terms: D004867:Equipment Design; D006801:Humans; D044582:Neuroendoscopes; D044583:Neuroendoscopy / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods
references.citation: World Neurosurg. 2014 Dec;82(6 Suppl):S72-80
references.pmid: 25496639
references.citation: Neurosurgery. 2007 Sep;61(3 Suppl):24-33; discussion 33-4
references.pmid: 17876230
references.citation: Surg Innov. 2015 Aug;22(4):390-3
references.pmid: 25049320
references.citation: J Urol. 2006 Oct;176(4 Pt 1):1313-6
references.pmid: 16952618
references.citation: Neurosurgery. 2008 Feb;62 Suppl 2:575-97; discussion 597-8
references.pmid: 18596446
references.citation: Ann Surg. 1918 Dec;68(6):569-79
references.pmid: 17864025
references.citation: Childs Nerv Syst. 2012 Jan;28(1):87-91
references.pmid: 21850468
references.citation: Neurosurgery. 2008 Feb;62 Suppl 2:599-606
references.pmid: 18596445
references.citation: Childs Nerv Syst. 2007 Jun;23(6):665-71
references.pmid: 17415571
references.citation: J Neurosurg. 2005 Jan;102(1 Suppl):113-8
references.pmid: 16206745
references.citation: Neurosurgery. 2009 May;64(5 Suppl 2):269-84; discussion 284-6
references.pmid: 19287324
references.citation: Minim Invasive Neurosurg. 2005 Oct;48(5):293-6
references.pmid: 16320192
references.citation: World Neurosurg. 2013 Feb;79(2 Suppl):S3-13
references.pmid: 23391453