A miniature
camera, light source, and surgical instruments slip through a rigid metal sleeve to enable neurosurgeons to explore the depths of the brain without excessively
cutting through healthy tissue.
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 ew equipment in Winthrop's Institute for Neurosciences is enabling neurosurgeons to look and operate deeply within the brain through an incision as small as a dime. The high-resolution neuroendoscopic device at Winthrop is among the most advanced of its kind on Long Island, and pediatric neurosurgeons Mark Mittler, MD, and Steve Schneider, MD, have been leading the way with this technology in both children and adults.
"The neuroendoscope allows us to visualize central portions of the brain, much in the same way that laparoscopic surgery allows general surgeons to operate through tiny incisions," explained Dr. Mittler.
The device acts as a rigid sleeve through which a fiberoptic camera, slightly larger than the head of a pin, is slipped. A miniaturized light source and tiny surgical instruments also fit through the sleeve. The camera's eye gives neurosurgeons an unprecedented view of the inner structures of the brain in an undisturbed state, without large incisions in the skull or the introduction of surgical instrumentation.
"This technique allows us to remove small tumors in a minimally invasive fashion," stated Dr. Mittler. "We can also treat hydrocephalus without the placement of permanent shunt hardware, open abnormal brain cysts, perform diagnostic biopsies of brain lesions, and look at deep-seated structures in the brain which we would not otherwise be able to see without large incisions through normal brain tissue."
Dark areas in the center of the image indicate fluid build up. After the minimally invasive procedure, the pockets of fluid were reduced in size and the patient’s condition improved.
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The device is particularly useful in performing endoscopic third ventriculostomy to treat some cases of hydrocephalus, or fluid build-up in the brain. Traditional treatment involves insertion of a silicone tube, or "shunt," which channels fluid from the spaces in the brain, called ventricles, to the abdomen. In the endoscopic procedure, neurosurgeons are able to puncture
a small hole at the base of the brain to enable the
built-up fluid to escape.
Other benefits of neuroendoscopic procedures include less pain, less wound healing, better cosmetic results, and sometimes a quicker recovery than with traditional, open neurosurgery.
"The inside of the brain can be compared to an elegant, delicate fabric, that, once cut, is never totally repaired," noted Alan Rosenthal, MD, Chief of Neurosurgery. "That is why a neuroendoscopic procedure, which requires a much smaller incision and less cutting, can be preferable to traditional surgery."
While neuroendoscopy has been in use for some time, Winthrop's new equipment represents the latest generation of this technology, providing extremely high resolution images that enhance the neurosurgeon's ability to visualize the brain's inner structures.
For additional information on Winthrop's Institute for Neurosciences, please call 1-866-NEURO-RX.
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