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

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.