Esperienza preliminare con endoscopio 4K: Analisi di pro e contro nella chirurgia del basicranio

Translated title of the contribution: Preliminary experience with 4K ultra-high definition endoscope: Analysis of pros and cons in skull base surgery

M. Rigante, Giuseppe La Rocca, L. Lauretti, G. Q. D’Alessandris, A. Mangiola, C. Anile, Alessandro Olivi, G. Paludetti

Research output: Contribution to journalArticle

Abstract

During the last two decades endoscopic skull base surgery observed a continuous technical and technological development 3D endoscopy and ultra High Definition (HD) endoscopy have provided great advances in terms of visualisation and spatial resolution. Ultra-high definition (UHD) 4K systems, recently introduced in the clinical practice, will shape next steps forward especially in skull base surgery field. Patients were operated on through transnasal transsphenoidal endoscopic approaches performed using Olympus NBI 4K UHD endoscope with a 4 mm 0° Ultra Telescope, 300 W xenon lamp (CLV-S400) predisposed for narrow band imaging (NBI) technology connected through a camera head to a high-quality control unit (OTV-S400 – VISERA 4K UHD) (Olympus Corporation, Tokyo, Japan). Two screens are used, one 31” Monitor – (LMD-X310S) and one main ultra-HD 55” screen optimised for UHD image reproduction (LMD-X550S). In selected cases, we used a navigation system (Stealthstation S7, Medtronic, Minneapolis, MN, US). We evaluated 22 pituitary adenomas (86.3% macroadenomas; 13.7% microadenomas). 50% were not functional (NF), 22.8% GH, 18.2% ACTH, 9% PRL-secreting. Three of 22 were recurrences. In 91% of cases we achieved total removal, while in 9% near total resection. A mean follow-up of 187 days and average length of hospitalisation was 3.09 ± 0.61 days. Surgical duration was 128.18± 30.74 minutes. We experienced only 1 case of intraoperative low flow fistula with no further complications. None of the cases required any post- or intraoperative blood transfusion. The visualisation and high resolution of the operative field provided a very detailed view of all anatomical structures and pathologies allowing an improvement in safety and efficacy of the surgical procedure. The operative time was similar to the standard 2D HD and 3D procedures and the physical strain was also comparable to others in terms of ergonomics and weight.

Original languageItalian
Pages (from-to)237-241
Number of pages5
JournalActa Otorhinolaryngologica Italica
Volume37
Issue number3
DOIs
Publication statusPublished - 2017
Externally publishedYes

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Keywords

  • 4K
  • Endoscopic sinus surgery
  • Endoscopy
  • Skull base
  • Ultra-high definition

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Rigante, M., La Rocca, G., Lauretti, L., D’Alessandris, G. Q., Mangiola, A., Anile, C., ... Paludetti, G. (2017). Esperienza preliminare con endoscopio 4K: Analisi di pro e contro nella chirurgia del basicranio. Acta Otorhinolaryngologica Italica, 37(3), 237-241. https://doi.org/10.14639/0392-100X-1684