Related Experiment Video
Updated: Mar 14, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Minimally Invasive Evacuation of Intracranial Hemorrhages Using the Aurora® Surgiscope System: Preliminary Experience
Vinay Jaikumar1,2, Jaims Lim1,2, Erika Leasher1
1Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA.
Background And Objectives:
Minimally invasive neuroendoscopic techniques for intracranial hemorrhage (ICH) have advanced, emphasizing reduced tissue damage, effective clot removal, and smaller incisions. We sought to assess the clinical utility of the Aurora® Surgiscope System (Integra LifeSciences) by analyzing volumetric reduction and outcomes associated with ICH clot evacuation.
Methods:
We retrospectively reviewed the records of patients undergoing ICH evacuation with the Surgiscope between July 1, 2019, and August 31, 2024. Demographics, comorbidities, symptoms, procedural details, and outcomes data were analyzed. Hemorrhage volumes were quantified before and after evacuation using 3D Slicer software. Volumes and outcomes in lobar (superficial) vs basal ganglia or thalami (deep-seated) ICH were statistically evaluated.
Results:
Thirty-one patients (median age: 68 years [IQR: 56.5-75]; 54.8% women) harboring 17 superficial and 14 deep-seated ICH were included. Using the Surgiscope, technical success was achieved in all cases, reducing median hemorrhage volume from 33.5 mL (IQR: 25.2-67.4) to 6.7 mL (IQR: 3.5-17.7), an 80.9% reduction (IQR: 54.4-89.9). The evacuation success rate was 93.5%, with 2 patients requiring reoperation. Superficial ICH demonstrated delayed Glasgow Coma Scale (GCS) score improvement after day 7 postprocedure (P = .01), whereas deep-seated ICH showed GCS score improvement as early as 48 hours (P = .04). Compared with patients with deep-seated ICH, patients with superficial ICH exhibited a dichotomous clinical course, experiencing neurological decline leading to a higher in-hospital death rate (47.1% vs 7.1%, P = .02) or excellent GCS scores among survivors at discharge (15 [15-15] vs 14 [13.8-15], P = .03). Postevacuation ICH volume remained the sole predictor of in-hospital mortality (adjusted odds ratio: 1.135 [95% CI: 1.016-1.268], P = .03) on multivariable regression.
Conclusion:
The Surgiscope showed promise as a safe, effective tool for minimally invasive ICH evacuation, with early neurological improvement in deep-seated hemorrhages and substantial volumetric reduction and a high evacuation success rate in all hemorrhages, providing valuable insights to guide minimally invasive ICH evacuation surgeries.
