—▼TOPICS—神経内視鏡および外視鏡の応用

Application of Neuroendoscope and Exoscope for Glioma Surgery

Point

・神経内視鏡手術は，深部型グリオーマに対して低侵襲での腫瘍摘出が可能である．

・ポートを用いる腫瘍摘出では腫瘍内部からの摘出になるため，腫瘍出血の制御に注意が必要である．

・外視鏡手術ではビデオカメラのポジションの自由度が高く，術者の視軸では得られないような鏡視軸での手術操作が可能となる．

・外視鏡手術は表層型グリオーマの摘出に応用でき，特に覚醒下手術では有用である．

　The recent progress of neuroendoscopy and exoscopy has yielded new strategies in neurosurgery, especially in glioma surgery. Neuroendoscopic port surgery makes it possible to remove deep-seated gliomas with minimal invasiveness. In port surgery, it is important to control tumor bleeding during intratumoral removal. As exoscopic systems have high flexibility of the video camera position, the surgical approach can be selected with various visual axes, which is difficult when using microscopic systems. Considering the characteristics of exoscopes, exoscopic surgery can be applied for the removal of superficial gliomas, and exoscopes are useful for glioma resection under awake craniotomy. However, there are outstanding tasks to improve surgical devices for neuroendoscopic surgery. The video quality and deep lighting of exoscopes are insufficient for general usage. Moreover, there are few training courses available for these surgical techniques. In the near future, based on these developments, neuroendoscopic and exoscopic surgeries may become more common treatments.