Application of the ISG Viewing Wand for Endoscopic Procedures
The use of intracranial endoscopy for operative procedures is increasing. Navigation within the ventricular system is straightforward, using known anatomical landmarks. Interactive image-guided surgical systems are helpful for defining the trajectory to the ventricular system and for performing endoscopy within cystic cavities where there are no landmarks for orientation. We have used the Viewing Wand system, a passive mechanical arm, with rigid endoscopes for the following applications: (1) defining the trajectory to the frontal horn for endoscopic III ventriculocisternostomy, colloid cyst removal, arachnoid cyst fenestration, or external ventricular drain placement (n = 5); (2) defining the trajectory to the ventricle from the occipital region for ventriculoperitoneal or cyst-peritoneal shunts (n = 4); (3) defining the trajectory to the frontal horn for shunt placement in cases of benign intracranial hypertension (n = 3); (4) fenestration of multiloculated parenchymal cysts occurring post brachytherapy (n = 3); and (5) placement of an Ommaya reservoir into a parenchymal cyst (n = 1). The system requires the use of rigid lens or fiberoptic endoscopes, custom measuring probes, and adapters to connect different endoscopes to the Viewing Wand. The operating room setup, probe adapters for rigid endoscopes with the Viewing Wand, and a single surgeon experience are presented.
Key wordsViewing Wand Endoscopy Image-guided surgery (IGS)
Unable to display preview. Download preview PDF.
- 1.Mapstone TB, Ratcheson RA (1996) Techniques of ventricular puncture. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. Williams and Wilkins, New York, pp 179–183Google Scholar
- 6.Kondziolka D, Lunsford LD (1995) Guided neurosurgery using the ISG Viewing Wand. Contemp Neurosurg 17: 1–6Google Scholar
- 7.Rhoten RLP, Luciano MG, Barnett GH (1997) Computer-assisted endoscopy for neurosurgical procedures: technical note. Neurosurgery 40: 6332–6338Google Scholar
- 11.Drake JM, Sainte-Rose C (1995) The shunt book. Blackwell, Ann Arbor, p 142Google Scholar
- 12.Drake JM, Sainte-Rose C (1995) The shunt book. Blackwell, Ann Arbor, p 118Google Scholar