World Neurosurg
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The Stealth Autoguide (Medtronic, Minneapolis, MN) is a robotic auto-targeting device for stereotactic brain biopsy, placement of stereoelectroencephalography electrodes, and laser ablation therapy. This paper evaluates its off-label application as robotic endoscope holder in transnasal and intraventricular neurosurgery. The potential to enhance stability, reduce manual adjustments, and improve surgical precision is discussed, alongside cost-effectiveness and feasibility. ⋯ This experience proves that the Stealth Autoguide can be safely and effectively used as a robotic support for endoscopic procedures. This device ensures precise positioning and manipulation of neuroendoscopes, facilitating visualization and targeting of the desired area. Further researches are needed to verify applications and limitations.
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Feasibility and safety of endoscopic endonasal approaches have become well established, and focus has now shifted to minimizing nasal morbidity. To this end, several modifications in the nasal stage have been described that focus primarily on preservation of nasal mucosa on right side of the nasal cavity. However, nasal mucosal preservation on the left side of the nasal cavity has largely been ignored. This technical note describes a modified technique that can eliminate mucosal damage in the left nasal cavity. ⋯ A combination of endonasal and transseptal approaches uses the advantages of both endoscopic and microscopic approaches sans the disadvantage of restricted space seen in microscopic approaches. It makes the binostril approach least disruptive to the left nasal mucosa and thus can reduce overall morbidity of endoscopic endonasal approaches.