Use of a nitrogen arm-stabilized endoscopic microdriver in neuroendoscopic surgery

Stabilization and manipulation of instruments in endoscopic neurosurgery has traditionally been a manual task. Conventional self-retaining retractors have failed to provide reliable fixation for endoscopic procedures. Most surgeons rely on a team approach to endoscopy with one individual controlling the endoscope while the other manipulates instruments within the field of view. This two-surgeon approach is manpower intensive and not an option at many facilities. Recently developed technology provides the independent practitioner with another option. Several nitrogen-powered stabilizing arms have been introduced which decrease or eliminate problems with post-positioning drift. To facilitate fine maneuvering of the endoscope, a new positioning arm is available with an incorporated microdriver capable of sub-millimeter adjustments. We present an illustrative case of the utility of this device in selected endoscopic procedures.