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Related Experiment Video

Updated: Jun 12, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Exoscopic Supraorbital Keyhole Approach for Skull Base Lesions: An Institutional Experience.

Bhanu Pratap Singh Chauhan1, Ketan Hedaoo2, Vijay Parihar2

  • 1Department of Neurosurgery, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India.

Asian Journal of Neurosurgery
|June 9, 2025
PubMed
Summary

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Endoscopic Transorbital Excision of an Intraconal Hemangioma.

Neurology India·2026

The exoscope supraorbital keyhole approach (ExSOKHA) offers a user-friendly, minimally invasive option for skull base lesions, reducing operative time and improving visualization compared to traditional methods. This technique facilitates learning neuroendoscopy and bridges the gap between microscope and endoscope use.

Area of Science:

  • Neurosurgery
  • Minimally Invasive Surgery
  • Skull Base Surgery

Background:

  • The supraorbital approach (SOKHA) is popular for anterior skull base lesions but faces visualization challenges with microscopes.
  • Endoscopic SOKHA offers advantages but has limitations like cost and learning curve.
  • The exoscope presents a potential solution to overcome microscope and endoscope limitations in SOKHA.

Purpose of the Study:

  • To evaluate the feasibility and usefulness of the exoscope in the supraorbital keyhole approach (ExSOKHA).
  • To assess the user-friendliness of the exoscope for surgeons transitioning from microscope to endoscope.
  • To determine if ExSOKHA is a viable minimally invasive technique for skull base lesions.

Main Methods:

  • A prospective observational study involving 50 patients over 7 years.
Keywords:
SOKHAexoscopemicroneurosurgeryneuroendoscopyskull base lesions

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  • Utilized a 2D VITOM rigid-lens exoscope system for skull base lesion surgeries.
  • Data collected on operative time, adjustments, complications, and patient outcomes.

    • Main Results:

    • ExSOKHA demonstrated good outcomes for pituitary adenomas, meningiomas, and aneurysms.
    • Low rates of complications such as frontal sinus opening (8%) and CSF leak (4%).
    • Reduced operative time, improved resection margins, and good cosmetic results were observed.

    Conclusions:

    • The exoscope enhances supraorbital keyhole surgery with better visualization, ergonomics, and maneuverability.
    • ExSOKHA is a user-friendly technique that can shorten learning curves for neuroendoscopy.
    • This approach effectively bridges the gap between microscope and endoscope, offering a viable minimally invasive option for skull base lesions.