Background: The use of endoscopes in neurosurgery is well established, but the integration of a full high definition signaling, 45° angled endoscopic tool into a digital surgical microscope, is new. We report our first experiences in a cadaveric study and a clinical case series using the new microinspection tool QEVO that serves as a plug-in feature for the recently launched KINEVO 900 digital visualization platform (CARL ZEISS MEDITEC, Oberkochen, Germany). For illustration purposes, we offer video footage.
Methods: The handling, workflow, and visualization patterns of the QEVO microinspection tool were critically evaluated in cadaver specimens by simulating four standardized neurosurgical approaches: (1) pterional, (2) retrosigmoidal, (3) transsphenoidal, (4) and transcallosal. Similarly, we evaluated the QEVO tool in corresponding clinical cases of (1) aneurysm clipping, (2) removal of cerebellar cavernoma, (3) and pituitary adenomectomy.
Results: In both the cadaveric study and clinical case series, the QEVO tool was found to be beneficial in terms of high-quality visualization of fine structures and for displaying hidden anatomical details ("looking around the corner"). The handling was good, and the workflow was easy. However, the use of this tool was restricted by the lack of an external fixation and a working channel, the shortness of the tool, and the impossibility to switch to a 0° or 30° optic.
Conclusion: Despite some restrictions, the QEVO microinspection tool is an innovative, handheld, endoscopic tool that allows excellent additional visualization of the surgical field. In our opinion, this tool effectively enhances the modern neurosurgical armamentarium.
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http://dx.doi.org/10.25259/SNI-45-2019 | DOI Listing |
Neurosurg Focus Video
January 2022
Department of Neurosurgery, University of Vermont Medical Center, Burlington, Vermont.
World Neurosurg
September 2022
Department of Neurosurgery, General Hospital Bamberg, Bamberg, Germany.
Background: Giant thoracic disk herniations are calcified hernias that fill >40% of the spinal canal and result in myelopathy with associated neurologic symptoms. This is a fairly rare abnormality that requires surgical treatment. Currently, there is no unambiguous opinion about the surgical approach to the treatment for this pathology.
View Article and Find Full Text PDFSurg Neurol Int
March 2022
Department of Neurosurgery, Emory University, Atlanta, Georgia, United States.
Background: Tuberculum sellae meningiomas represent approximately 5-10% of intracranial meningiomas.[2] Although benign, they are associated with substantial morbidity, especially visual disturbance. At present, there are three main treatment options for patients with tuberculum sellae meningiomas: observational, with serial imaging follow; microsurgical resection; and stereotactic radiosurgery.
View Article and Find Full Text PDFWorld Neurosurg
February 2022
Department of Neurosurgery, Emory University, Atlanta, Georgia, USA. Electronic address:
We present the case of a 23-year-old female with a history of progressive hearing loss in the left ear, dizziness, and vertigo. Magnetic resonance imaging demonstrated a left mass extending from the internal auditory canal into the cerebellopontine angle (Koos-4). A retrosigmoid approach assisted with a microinspection tool was chosen.
View Article and Find Full Text PDFWorld Neurosurg
January 2022
Department of Neurosurgery, Emory University, Atlanta, Georgia, USA. Electronic address:
The authors present the case of a 52-year-old male with a history of new-onset seizures who presented in status epilepticus. Computed tomography and magnetic resonance imaging demonstrated an olfactory groove mass. A keyhole supraorbital-eyebrow approach assisted with a microinspection tool was performed for tumor resection.
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