Multidirectional projectional rigid neuro-endoscopy: prototype and initial experience

Area of Science:

• Neurosurgery
• Medical Imaging
• Endoscopic Technology

Background:

• Traditional neuro-endoscopy is limited by 2D views, complicating surgical interventions.
• A novel rigid endoscope with variable direction view has been developed to provide 3D visualization.
• This technology aims to overcome the limitations of current endoscopic approaches in neurosurgery.

Purpose of the Study:

• To evaluate the performance of a new multidirectional endoscope (EndActive) against standard neuro-endoscopes.
• To assess the visualization capabilities and accuracy in identifying structures within brain models.
• To compare the efficacy of the EndActive endoscope in a simulated neurosurgical environment.

Main Methods:

• A prototype EndActive endoscope with a 360-degree variable view controlled by a joystick was tested on two brain models.
• Performance was compared to standard rigid endoscopes (0, 30, 70 degrees) and a projection map.
• Ten neurosurgeons evaluated the endoscope's accuracy in identifying labeled projections and simulated intraventricular tumors.

Main Results:

• The multidirectional endoscope visualized all 8 markers, unlike standard endoscopes (max 4/8).
• It demonstrated higher accuracy in marker identification (p=0.031) and identified 96% of simulated tumors.
• The best performance in identification tasks was achieved using the flat projection map derived from the endoscope data.

Conclusions:

• The EndActive endoscope provides complete 3D visualization through adjustable viewing direction.
• This multidirectional endoscope offers superior visualization compared to standard neuro-endoscopy.
• The technology has the potential to enhance surgical precision and outcomes in neurosurgical procedures.