Image-guided endoscopy: description of technique and potential applications

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  • Seattle Neuroscience Institute, Seattle, Washington; and Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio
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Object

Neuroendoscopic approaches to lesions of the central nervous system and spine are limited by the loss of stereoscopic vision and high-fidelity image quality inherent in the operating microscope. Image-guided endoscopy (IGE) and image-guided surgery (IGS) have the potential to overcome these limitations. The goal of this study was to evaluate IGE for its potential applications in neurosurgery.

Methods.

To determine the feasibility of IGE, a rigid endoscope was tracked using an IGS system that provided navigational data for the endoscope tip and trajectory as well as a computer-generated, three-dimensional, virtual representation of the image provided by the endoscope.

The IGE procedure was successfully completed in 14 patients (nine with pituitary adenomas, one with a temporal cavernous malformation, and four with unruptured aneurysms). No complications could be attributed to the procedure. Compared with direct microscopy performed using anatomical landmarks, registration of the endoscope, and virtual image were highly accurate.

Conclusions

This procedure offers many potential advantages for central nervous system and spinal endoscopy. Advances in IGE may enable its application to regions outside the central nervous system as well.

Abbreviations used in this paper:

IGE = image-guided endoscopy; IGS = image-guided surgery; MR = magnetic resonance; 3D = three-dimensional.

Object

Neuroendoscopic approaches to lesions of the central nervous system and spine are limited by the loss of stereoscopic vision and high-fidelity image quality inherent in the operating microscope. Image-guided endoscopy (IGE) and image-guided surgery (IGS) have the potential to overcome these limitations. The goal of this study was to evaluate IGE for its potential applications in neurosurgery.

Methods.

To determine the feasibility of IGE, a rigid endoscope was tracked using an IGS system that provided navigational data for the endoscope tip and trajectory as well as a computer-generated, three-dimensional, virtual representation of the image provided by the endoscope.

The IGE procedure was successfully completed in 14 patients (nine with pituitary adenomas, one with a temporal cavernous malformation, and four with unruptured aneurysms). No complications could be attributed to the procedure. Compared with direct microscopy performed using anatomical landmarks, registration of the endoscope, and virtual image were highly accurate.

Conclusions

This procedure offers many potential advantages for central nervous system and spinal endoscopy. Advances in IGE may enable its application to regions outside the central nervous system as well.

Abbreviations used in this paper:

IGE = image-guided endoscopy; IGS = image-guided surgery; MR = magnetic resonance; 3D = three-dimensional.

Contributor Notes

Address reprint requests to: Marc Mayberg, M.D., Seattle Neuroscience Institute, 1600 Jefferson Avenue, Suite 620 Seattle, Washington 98104. email: marc.mayberg@swedish.org

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