Skip to main content
SpringerLink
Log in

Actual state of EndActive ventricular endoscopy

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

Abstract

Purpose

We assessed usability and applicability of a rigid, multidirectional steerable videoendoscope (EndActive, Karl Storz GmbH, Tuttlingen, Germany) for endoscopic third ventriculostomy and compared our experience with reports about other multidirectional endoscopes.

Methods

The prototype is a 4-mm-diameter rigid videoendoscope with an integrated image sensor comprising an embedded light source, offering a free viewing direction in a range of 160° while the tip itself does not move. In five specimens (ten sides), we introduced the endoscope via precoronal burr holes through the lateral ventricle and foramen of Monro into the third ventricle. The endoscope's tip was positioned at the level of the mamillary bodies and the previously defined anatomical target structures; anteriorly, the optic chiasm, anterior commissure, infundibulum, tuber cinereum and posteriorly, the entrance to the mesencephalic aqueduct and posterior commissure were inspected.

Results

A single insertion of the videoendoscope was sufficient to explore with the multiplanar viewing mechanism the entire third ventricle. The prototype videoendoscope may be held like a microsurgical instrument in one hand. It is feasible to control movements precisely due to the reduced weight and ergonomic shape of the device.

Conclusions

The prototype EndActive has the potential to fit in the current concept of ETV and enrich the setting adding working economy and viewing variability.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Aryan HE, Hoeg HD, Marshall LF, Levy ML (2005) Multidirectional projectional rigid neuro-endoscopy: prototype and initial experience. Minim Invasive Neurosurg 48:293–296

    Article  PubMed  CAS  Google Scholar 

  2. Dincer A, Yildiz E, Kohan S, Memet Özek M (2011) Analysis of endoscopic third ventriculostomy patency by MRI: value of different pulse sequences, the sequence parameters, and the imaging planes for investigation of flow void. Childs Nerv Syst 27:127–135

    Article  PubMed  Google Scholar 

  3. Di Rocco C, Massimi L, Tamburrini G (2006) Shunts vs endoscopic third ventriculostomy in infants: are there different types and/or rates of complications? A review. Childs Nerv Syst 22:1573–1589

    Article  PubMed  Google Scholar 

  4. Ebner FH, Marquardt JS, Hirt B, Feigl GC, Tatagiba M, Schuhmann MU (2010) Broadening horizons of neuroendoscopy with a variable-view rigid endoscope: an anatomical study. Eur J Surg Oncol 36:195–200

    Article  PubMed  CAS  Google Scholar 

  5. Enchev Y, Oi S (2008) Historical trends of neuroendoscopic surgical techniques in the treatment of hydrocephalus. Neurosurg Rev 31:249–262

    Article  PubMed  Google Scholar 

  6. Grunert P, Gaab MR, Hellwig D, Oertel JM (2009) German neuroendoscopy above the skull base. Neurosurg Focus 27:E7

    Article  PubMed  Google Scholar 

  7. Hopf NJ (1999) Endoscopic neurosurgery "around the corner" with a rigid endoscope. Technical note. Minim Invasive Neurosurg 42:27–31

    Article  PubMed  CAS  Google Scholar 

  8. Jones RF, Kwok BC, Stening WA, Vonau M (1994) The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus. Minim Invasive Neurosurg 37:28–36

    Article  PubMed  CAS  Google Scholar 

  9. Kim K, Kim D, Matsumiya K, Kobayashi E, Dohi T (2005) Wide FOV wedge prism endoscope. Proceedings of the 2005 IEEE. Engineering in Medicine and Biology 27th Annual Conference. 5758–5761

  10. Kulkarni AV, Shams I, Cochrane DD, McNeely PD (2010) Quality of life after endoscopic third ventriculostomy and cerebrospinal fluid shunting: an adjusted multivariable analysis in a large cohort. J Neurosurg Pediatr 6:11–16

    Article  PubMed  Google Scholar 

  11. Kunz M, Schulte-Altedorneburg G, Uhl E, Schmid-Elsaesser R, Schöller K, Zausinger S (2008) Three-dimensional constructive interference in steady-state magnetic resonance imaging in obstructive hydrocephalus: relevance for endoscopic third ventriculostomy and clinical results. J Neurosurg 109:931–938

    Article  PubMed  Google Scholar 

  12. Levy ML, Nguyen A, Aryan H, Jandial R, Meltzer HS, Apuzzo ML (2006) Robotic virtual endoscopy: development of a multidirectional rigid endoscope. Neurosurgery 59:134–141

    Article  Google Scholar 

  13. Mixter WJ (1923) Ventriculoscopy and puncture of the floor of the third ventricle. Boston Med Surg J 188:277–278

    Article  Google Scholar 

  14. Oertel J, Gen M, Krauss JK, Zumkeller M, Gaab MR (2006) The use of waterjet dissection in endoscopic neurosurgery. Technical note. J Neurosurg 105:928–931

    Article  PubMed  Google Scholar 

  15. Oi S, Samii A, Samii M (2005) Frameless free-hand maneuvering of a small-diameter rigid-rod neuroendoscope with a working channel used during high-resolution imaging. Technical note. J Neurosurg 102:113–118

    PubMed  Google Scholar 

  16. Schmidt RH (1999) Use of a microvascular Doppler probe to avoid basilar artery injury during endoscopic third ventriculostomy. Technical note. J Neurosurg 90:156–159

    Article  PubMed  CAS  Google Scholar 

  17. Schroeder HW, Oertel J, Gaab MR (2004) Incidence of complications in neuroendoscopic surgery. Childs Nerv Syst 20:878–883

    Article  PubMed  Google Scholar 

  18. Riegel T, Alberti O, Retsch R, Shiratori V, Hellwig D, Bertalanffy H (2000) Relationships of virtual reality neuroendoscopic simulations to actual imaging. Minim Invasive Neurosurg 43:176–180

    Article  PubMed  CAS  Google Scholar 

  19. Rohde V, Reinges MH, Krombach GA, Gilsbach JM (1998) The combined use of image-guided frameless stereotaxy and neuroendoscopy for the surgical management of occlusive hydrocephalus and intracranial cysts. Br J Neurosurg 12:531–538

    Article  PubMed  CAS  Google Scholar 

  20. van Beijnum J, Hanlo PW, Fischer K, Majidpour MM, Kortekaas MF, Verdaasdonk RM, Vandertop WP (2008) Laser-assisted endoscopic third ventriculostomy: long-term results in a series of 202 patients. Neurosurgery 62:437–443

    Article  PubMed  Google Scholar 

  21. Zimmermann M, Krishnan R, Raabe A, Seifert V (2002) Robot-assisted navigated neuroendoscopy. Neurosurgery 51:1446–1451

    PubMed  Google Scholar 

Download references

Conflict of interest statement

The present study was sponsored by Karl Storz GmbH, Tuttlingen, Germany, on request of the authors with regard to the costs of the anatomical specimens. Karl Storz supplied the EndActive for the time of laboratory investigation. Karl Storz did not influence the study design and collection, analysis and interpretation of data. The decision to submit the manuscript for publication was taken exclusively by the authors, which have no financial and personal relationship to Karl Storz and its representatives.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Eberhard-Karls-University, Tübingen, Germany

    Florian H. Ebner, Jakob S. Marquardt, Stephan Herlan, Marcos Tatagiba & Martin U. Schuhmann

  2. Institute of Clinical Anatomy, Eberhard-Karls-University, Elfriede-Aulhorn-Street 8, 72076, Tübingen, Germany

    Bernhard Hirt & Stephan Herlan

Authors
  1. Florian H. Ebner
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bernhard Hirt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jakob S. Marquardt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephan Herlan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marcos Tatagiba
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Martin U. Schuhmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Bernhard Hirt.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ebner, F.H., Hirt, B., Marquardt, J.S. et al. Actual state of EndActive ventricular endoscopy. Childs Nerv Syst 28, 87–91 (2012). https://doi.org/10.1007/s00381-011-1537-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-011-1537-3

Keywords

Search

Navigation