INTERACTIVE IMAGE-GUIDED NEUROENDOSCOPY - DEVELOPMENT AND EARLY CLINICAL-EXPERIENCE

Technical advances and pioneering surgeons have established neuroendos copy as an accepted diagnostic and therapeutic tool. The clinical indi cations for endoscopy, variety of operative techniques and number of e ndoscopic surgeons continue to increase steadily. However, there are f undamental limits to the scope of freehand endoscopy principally gover ned by the need for direct vision of anatomical and pathological struc tures. In addition, whilst the expert neuroendoscopist is only occasio nally disorientated by complex distorted anatomy, the rising number of novices are likely to be mislead relatively often. We report the inte gration of neuroendoscopy with an optical neuronavigation system to pr ovide interactive image-guided neuroendoscopy. This combination both r emoves the constraining requirement for direct vision and provides acc urate localisation to guide the surgeon during surgery. We describe th e clinical application of this method to two cases where image-guided endoscopy was essential to the safe completion of the procedure.