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[Development and clinical application of a brain stereotactic endoscope]
1Department of Neurosurgery, Huashan Hospital, Shanghai Medical University, Shanghai 200040.
Objective:
To investigate the feasibility, indications and advantages of endoscopic surgery for brain neoplasms and hypertensive haematoma.
Method:
A self-designed brain endoscope with a wide working channel was used for resection of deep-seated brain neoplasm or other cranial cerebral operations of 30 patients operated on endoscopically, 13 had intracranial tumor, 15 hypertensive intracerebral haematoma, 1 thalamic abscess, and 1 cysticercosis.
Result:
Total removal of tumor was achieved in 4 patients, subtotal or major partial removal in 7, and biopsy in 2. Completely evacuation of haematoma was achieved in 7 patients and partial evacuation in 8 (over 80%). The abscess was evacuated and the solitary cysticercosis focus was removed with our endoscope. No obvious postoperative complications were noted.
Conclusion:
The advantages of stereotactic endoscopy for deep-seated brain neoplasm include accurate intraoperative localization, minimal invasion, good recovery, no or a few complications. The indications for this intervention are small lesions deep in the brain parenchyma with well-defined boundary and light vascularity. Intracerebral haematoma can be evacuated under direct vision endoscopically, without damage to the haematoma cavity wall.