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Multiportal Retrograde Endoscopy to Enhance Surgical Target Visualization: A Pilot Study.

Neeraja Konuthula1, Randall A Bly1,2, Waleed M Abuzeid1

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|July 5, 2024
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Summary
This summary is machine-generated.

Multiportal retrograde endoscopy enhances surgical visualization by providing an additional perspective during sinus and skull base procedures. This technique improves instrument manipulation and target visualization beyond standard rigid endoscopy.

Keywords:
endoscopic surgerymultiportalreverse perspective endoscopysinus and skull base surgery

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Surgical Technology

Background:

  • Current transnasal endoscopic surgery relies on a single endoscope, limiting depth perception and instrument visualization.
  • This single perspective can lead to blocked views and instrument collisions during sinus and skull base procedures.

Purpose of the Study:

  • To investigate the utility of multiportal retrograde endoscopy for improved surgical target manipulation.
  • To assess if retrograde endoscopy offers enhanced visualization compared to standard transnasal endoscopy.

Main Methods:

  • Maxillary antrostomy and frontal sinusotomy were performed on three cadavers using both standard rigid transnasal endoscopy and multiportal retrograde endoscopy.
  • A flexible endoscope was inserted transorally for a retrograde view, recorded simultaneously with the standard transnasal view.

Main Results:

  • Dual-screen viewing of standard and retrograde perspectives was successfully implemented.
  • Surgeons utilized the retrograde view to refine instrument tip placement.
  • Reviewing surgeons agreed that the retrograde view offered a unique perspective not achievable with rigid endoscopy alone.

Conclusions:

  • High-quality visualization of surgical targets like the frontal or maxillary ostia is challenging with rigid endoscopes alone.
  • Multiportal retrograde endoscopy demonstrates proof of concept for achieving additional views of surgical targets.
  • Further research is required to establish indications, refine techniques, and expand generalizability to other surgical targets.