A single-port operator-controlled flexible endoscope system for endoscopic skull base surgery.

Area of Science:

• Neurosurgery
• Otolaryngology
• Endoscopic Surgery

Background:

• Skull base surgery presents complex anatomical challenges.
• Minimally invasive techniques are continually being explored to improve patient outcomes.
• Flexible endoscopy offers potential advantages in navigating confined surgical spaces.

Purpose of the Study:

• To evaluate the feasibility and utility of a single-port, operator-controlled flexible endoscope (Flex® System) for skull base surgery.
• To assess the system's capability for visualizing and manipulating key anatomical structures during simulated surgical procedures.

Main Methods:

• A human cadaveric study involving four specimens was conducted.
• The Flex® System, equipped with a high-definition camera and accessory channels, was utilized.
• A modified surgical midfacial approach was employed for access to the sinus system, skull base, and middle cranial fossa.

Main Results:

• Endoscopic visualization of the skull base using the Flex® System was found to be feasible.
• Surgical procedures included extended sinus surgery, anterior skull base approaches, and brainstem visualization.
• Key anterior skull base landmarks were successfully visualized and manipulated using flexible instruments.

Conclusions:

• The Flex® System shows promise for anterior skull base manipulation and posterior cranial fossa visualization in a preclinical setting.
• Further research and development of complementary tools are warranted to optimize its application in skull base surgery.