Actual state of EndActive ventricular endoscopy.

Area of Science:

• Neurosurgery
• Medical Device Technology
• Endoscopic Surgery

Background:

• Endoscopic third ventriculostomy (ETV) is a key neurosurgical procedure.
• Advancements in endoscopic technology are crucial for improving surgical outcomes.
• Multidirectional steerable endoscopes offer potential advantages in visualizing complex neuroanatomy.

Purpose of the Study:

• To assess the usability and applicability of the rigid, multidirectional steerable videoendoscope (EndActive) for ETV.
• To compare the experience with EndActive to existing multidirectional endoscopes.

Main Methods:

• A prototype 4-mm-diameter rigid videoendoscope with a 160° viewing range was used.
• The endoscope was inserted via precoronal burr holes into the lateral and third ventricles in five human specimens.
• Anatomical structures including the optic chiasm, anterior commissure, and mamillary bodies were inspected.

Main Results:

• A single insertion allowed complete exploration of the third ventricle using the multiplanar viewing mechanism.
• The prototype videoendoscope can be held like a microsurgical instrument.
• Precise movement control was achieved due to the device's reduced weight and ergonomic design.

Conclusions:

• The EndActive prototype shows potential for integration into current ETV concepts.
• The device may improve working economy and viewing variability in endoscopic neurosurgery.
• Further evaluation of this steerable endoscope for ETV is warranted.