第38回日本小児神経外科学会
The 38th Annual Meeting of the Japanese Society for Pediatric Neurosurgery

次の演題

第2日目、6月5日(土)A 会場(3階 メインホール)8:20〜9:30

シンポジウム 4: 神経内視鏡治療の適応と問題点

座長: 冨永悌二、林 央周

S4-1

Expanded Indication for Neuroendoscopic Surgery by "Frameless Free-hand Technique" with the World-finest Rigid-rod Neuroendoscope ["Oi Handy Pro"]
世界最小径高画質硬性神経内視鏡 [“Oi Handy Pro”] による“Frameless Free-hand Technique” がもたらした神経内視鏡手術の適応拡大

OI Shizuo, TAMOGAMI Rei, NONAKA Yuichirou, MIWA Tomoru, SAITOU Katsuya

Jikei University Hospital Women's and Childrens' Medical Center JWCMC, Tokyo, Japan

Objective: The authors developed the world-finest rigid-rod neuroendoscopy with 2-mm diameter high-resolution lens and 3 working channels ["Oi Handy Pro", Karl Storz, Tuttlingen, Germany](Journal of Neurosurgery 102: 113-118, 2005). The neuroendoscope was designed as a light, handheld tool and 4.0 x 2.6 mm at maximum diameter. In this report, we describe the surgical technique of the "Frameless Free-hand Maneuvering" with this newly designed fine-neuroendoscopy and analyzed the the surgical applications of this neuroendoscopy cosequently expanded not only to lesions related with the Cerebro-Spinal Fluid (CSF) circulation but also to management of intracranial tumors and others.Clinical Materials: Between 2001 and 2007 at JWCMC, there were 30 out of 305 hydrocephalus patients (9.8%) were treated with neuroendoscopic ventriculostomy by this technique, and 17/59 patients (28.8%) with intracranial cyst and 24/98 patients (24.4%) with brain tumor were operated only with this neuroendoscopy surgical technique. Results and Conclusion: "Frameless Free-Hand Maneuvering" with "Oi Handy Pro" could be applied to the various intraventricular lesions with combined neuronavigational neuroendoscopic technique, even not only with ventriculomegaly but also even via slit-like ventricle. In dealing with these various pathological lesions, the application / indication for neuroendoscopic surgery expanded more with achievement of the most-advanced technique, "Frameless Free-Hand Maneuvering".

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