scholarly journals The development of a virtual simulator for a novel design surgical tool in endoscopic endonasal transsphenoidal surgery

2021 ◽  
Vol 10 (3) ◽  
pp. 1368-1379
Author(s):  
Nantida Nillahoot ◽  
Branesh M. Pillai ◽  
Sorayouth Chumnanvej ◽  
Jackrit Suthakorn
Keyword(s):  
Transsphenoidal Surgery ◽  
Standard Procedure ◽  
Minimal Invasive ◽  
Surgical Simulator ◽  
Endoscopic Endonasal ◽  
Steep Learning Curve ◽  
Surgical Tool ◽  
Learning Skill ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Novel Design

Endoscopic endonasal transsphenoidal surgery (EETS) is a standard procedure to treat the pituitary adenoma, a tumor in the pituitary gland that causes malfunction of hormones. Although the method is substantially minimal invasive, the surgeon may encounter intricacies. The major challenges are narrow surgery pathway, limited working area, lack of case studies for practicing, steep learning curve owing to the intricate steps, and the tool insertion risk. To ease the neurosurgeons, this research focuses on the development and testing of the surgical simulator based on the pathway guidance and the interchangeable surgical instrument tooltip. The system was tested in human cadaver-based experiments with interchangeability in terms of function and the performance of the simulator in terms of the benefits. The experiments demonstrate the augmentation in the learning skill of the user through the simulator based on the completion time assessment and the error reduction. Furthermore, the satisfaction level of the interchangeable surgical tool, which was found using sliding switch and gripper scored 71.40%, the interchangeable tooltip function, which is a novel function to participants scored 85.6% and the practical use had 77%. The geometric aspect of the interchangeable tool scored lowest (62.80%) and was found to be moderate among the neurosurgeons.

scholarly journals The Angelina Dissectors: A Novel Design of Dissectors for Endoscopic Endonasal Approaches

2019 ◽  
Vol 81 (03) ◽  
pp. 295-300
Author(s):  
Alexandre B. Todeschini ◽  
Bradley A. Otto ◽  
Ricardo L. Carrau ◽  
Daniel M. Prevedello
Keyword(s):  
Patient Outcome ◽  
Transsphenoidal Surgery ◽  
Standard Procedure ◽  
Major Change ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Sellar Lesions ◽  
New Instruments ◽  
Novel Design

Background The description and refinement of the transsphenoidal approach would not be possible without new tools and technologies developed by surgeons to facilitate this approach, which is nowadays the standard procedure for more than 90% of sellar lesions. The latest major change in transsphenoidal surgery was the introduction of the rigid endoscope and the subsequent description of the endoscopic endonasal approach. Traditional bayoneted instruments, when used for this technique, were inadequate. New instruments designed, specifically for this technique, are necessary to facilitate the surgeon's work and improve patient outcome. Objective This study describes a novel design of dissectors created specifically for endoscopic endonasal approaches. Methods To develop and design the Angelina dissectors, we used our extensive surgical experience to identify the shortcomings of the available dissectors used for transsphenoidal surgery and created the Angelina dissectors. Results The Angelina dissector was designed with a unique shaft shape which facilitates endoscopic endonasal surgery. Conclusion Even though an endoscopic endonasal approach is possible using other instruments, the design of these dissectors aids the surgeon's work. It is our impression, based on personal experience that it allows more freedom of movement and dexterity during the procedure, which could translate as an improved patient outcome.

scholarly journals Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Macroadenoma as Minimal Invasive Approach: Case Report

2019 ◽  
Vol 3 (1) ◽  
pp. 1
Author(s):  
Febyan Febyan ◽  
Handrianto Setiajaya
Keyword(s):  
Minimally Invasive ◽  
Transsphenoidal Surgery ◽  
Clinical Symptoms ◽  
Minimal Invasive ◽  
Invasive Technique ◽  
Endoscopic Endonasal ◽  
Invasive Approach ◽  
Minimal Invasive Approach ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Visual Disturbances

Background: pituitary tumor accounted for 15% of benign intracranial tumors. Clinical symptoms found in the form of visual disturbances, and hormonal manifestations, surgery is one of the main managements. Endoscopic endonasal transsphenoidal surgery (EETS) is a minimally invasive approach for this case. The advantages of EETS is better efficacy than traditional technique, and shorter hospital stays, less mean blood loss, and earlier return to daily activities. Case: we reported a rare example of a male patient aged 37 years old with the main clinical features were visual disturbances, sexual malfunction and bitemporal hemianopsia on physical examination. Magnetic resonance imaging (MRI) showed macroadenoma pituitary, the size 2.41 x 2.98 x 3.20 cm. We explained about minimally invasive surgery such as EETS and the patient was agreed to performed EETS. Conclusion: endoscopic endonasal transsphenoidal surgery is a minimally invasive technique for tumor pituitary cases and safe when compared to traditional medicine.

scholarly journals Application of 3D printed model for planning the endoscopic endonasal transsphenoidal surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xing Huang ◽  
Ni Fan ◽  
Hai-jun Wang ◽  
Yan Zhou ◽  
Xudong Li ◽  
...  
Keyword(s):  
3D Printing ◽  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Three Dimensional ◽  
Spatial Relationship ◽  
Cranial Computed Tomography ◽  
Imaging Data ◽  
Endoscopic Endonasal ◽  
Endoscopic Endonasal Transsphenoidal Surgery

AbstractThe application of 3D printing in planning endoscopic endonasal transsphenoidal surgery is illustrated based on the analysis of patients with intracranial skull base diseases who received treatment in our department. Cranial computed tomography/magnetic resonance imaging data are attained preoperatively, and three-dimensional reconstruction is performed using MIMICS (Materialise, Leuven, Belgium). Models of intracranial skull base diseases are printed using a 3D printer before surgery. The models clearly demonstrate the morphologies of the intracranial skull base diseases and the spatial relationship with adjacent large vessels and bones. The printing time of each model is 12.52–15.32 h, and the cost ranges from 900 to 1500 RMB. The operative approach was planned in vitro, and patients recovered postoperatively well without severe complications or death. In a questionnaire about the application of 3D printing, experienced neurosurgeons achieved scores of 7.8–8.8 out of 10, while unexperienced neurosurgeons achieved scores of 9.2–9.8. Resection of intracranial skull base lesions is demonstrated to be well assisted by 3D printing technique, which has great potential in disclosing adjacent anatomical relationships and providing the required help to clinical doctors in preoperative planning.

Calvian Endo-pen: New Coagulation Forceps for Endoscopic Endonasal Transsphenoidal Surgery

2018 ◽  
Vol 79 (06) ◽  
pp. 524-527
Author(s):  
Steffen Rosahl ◽  
Geralf Kellner ◽  
Rüdiger Gerlach
Keyword(s):  
Skull Base ◽  
Transsphenoidal Surgery ◽  
Endoscopic Endonasal ◽  
Small Vessels ◽  
The Past ◽  
Bipolar Electrocoagulation ◽  
New Type ◽  
Endoscopic Endonasal Transsphenoidal Surgery ◽  
Skull Base Lesions ◽  
Anatomical Area

Objective Over the past few years bipolar electrocoagulation techniques in neurosurgery have been continually improving. However, limited access during endoscopic endonasal transsphenoidal surgery (EETS) for central skull base pathologies and the requirement of very precise coagulation in that dedicated anatomical area requires further refinement of bipolar coagulation instruments. We describe our experience (effectiveness of coagulation, intraoperative handling, and the use as a dissecting tool) with a new type of coagulation forceps, the Calvian endo-pen (Sutter Medizintechnik, Freiburg, Germany) during EETS. Method From June to August 2015, 12 patients with central skull base lesions (9 with a pituitary adenoma and 1 each with epidermoid, hemangioma, and juvenile angiofibroma) were operated on with the Calvian endo-pen. Results The application of the Calvian endo-pen was feasible in all cases. The angled thin tips proved to be very effective and precise for soft tissue coagulation to achieve hemostasis. Even very small vessels could be occluded selectively. It was also helpful for outward dissection in separating normal from tumor tissue. Conclusion The use of the Calvian endo-pen is safe and effective during EETS for central skull base pathologies. Its ease in intraoperative handling (maneuverability, cleaning) and precise coagulation makes it a promising instrument for EETS.

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