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Advanced Neuro Endoscopy
The document discusses advanced techniques in neuroendoscopy, focusing on endoscopic navigation and minimally invasive surgical procedures. It presents case studies detailing treatment plans and outcomes for patients with conditions like thalamic astrocytoma and pineal tumors, highlighting the use of advanced imaging and neuronavigation. Additionally, it emphasizes the technological advancements in surgical instruments and imaging that enhance procedural precision.
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Advanced Neuro Endoscopy
- 1. Advanced Endoscopic Navigation M. Triffaux StealthUsers Meeting 17 March 2006
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- 3. Neuroendoscopy • « MinimallyInvasive Surgery » Ventriculoscopy Pituitary Key hole surgery
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- 6. Neuroendoscopy • Ventriculoscopy – Ventriculocisternostomie – Shunt révision – Biopsy
- 7. Neuroendoscopy • Endoscopic biopsy – Ventricular tumor pineal tumor
- 8. Neuroendoscopy • Endoscopic biopsy – Ventricular tumor – Paraventricular tumor astrocytoma thalamic
- 9. Neuroendoscopy • Endoscopic biopsy – Ventricular tumor – Paraventricular tumor – Ventricular cyst
- 10. Neuroendoscopy • Our choice:MINOP B Braun Aesculap – Maneuverabilty trocars, instruments. – Lensscope with 90°-angled
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- 12. Neuronavigation: Personal experience • 1996MKM C.H.R. Citadelle Liège • 1999 Stealth Station Sofamor Danek • 2005 Stealth Tria Plus
- 13. Advanced Neuronavigation • Newpossibilities – StealthMerge: fusion of multiple data sets auto merge compatible with CT, MR, Pet scan – Advanced 3D image – Tip extension
- 14. Advanced Neuronavigation • StealthMerge Ct scan MR Pet scan
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- 21. Advanced Neuronavigation • Tipextension
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- 23. Endoscopic Navigation • Surgicalplanning – Choice entry point and trajectory
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- 25. Endoscopic Navigation • SureTrak endoscope tracking
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- 28. Endoscopic Navigation • Illustrationcase 1 – 16 y.o. !, Parinaud’s syndrome – CT MR imaging: left thalamus mass hydrocephalus – Pet FDG – methionine +
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- 31. Endoscopic Navigation • Illustrationcase 1 Mass effect on Monro f. Left approach Hydrocephalus aspect of Monro f.
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- 33. Endoscopic Navigation • Illustrationcase 1 Left biopsy
- 34. Endoscopic Navigation • Illustrationcase 1 Right ETV
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- 36. Endoscopic Navigation • Illustrationcase 1 J10 post ETV & biopsyPre operative
- 37. Endoscopic Navigation • Illustrationcase 1 – Diagnosis: astrocytoma III – Treatement: conventional surgery astrocytoma III was confirmed
- 38. Endoscopic Navigation • Illustrationcase 2 – 21 y.o. ", recent diplopia – CT MR imaging: pineal tumor – Pet methionine: + – Blood α fetoproteine , βHCG: nl < 1 mUI/ml – CSF α fetoproteine: nl, βHCG: & 3 mUI/ml
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- 42. Endoscopic Navigation • Illustrationcase 2 – Treatment: chemotherapy & radiotherapy 2 cycles carbo/ etoposide / Ifosfamide 40 Gy radiotherapy 15 X 1.6 Gy ( GTV + 1.5cm + ventricules) = 24 Gy 10 X 1.6 Gy ( GTV + 1.5cm ) = 16 Gy
- 43. Endoscopic Navigation • Illustrationcase 2 – Treatment: chémothérapy & radiotherapy
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