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Neuro endoscopy: Pushing the frontiers of neurosurgery

Neurosurgery has evolved from the era of trephination to modern mcroneurosurgery over the last century.Victor Darwin Lespinasse used urethroscope to visualize the cerebral ventricle andperformed choroid plexectomy for which he is acknowledged as the “Father of Neuroendoscopy.” Since then several advances in technology, optics,instrumentation and video imaging has led to dramatic improvements in neuroendoscopy. This has been accompanied by a steady progress in innovation, applications and indications.

Neuro endoscopy has emerged as the preferred technique for treating hydrocephalus almost replacing the conventional shunts. Along with its growing popularity, applications using a rigid endoscope have expanded and are now used to treat intraventricular cysts, cerebral cysts, intraventricular tumors multi-loculated hydrocephalus and septostomy. Further, the arrival of fibreoptic flexible endoscopy has meant that doctors can now access more critical areas paving the way for acqueductoplasty, biopsy of pineal and 4th ventricular lesions.

Developments in optics and video systems have contributed immensely to this evolutionary process. With 3D cameras surgeons have overcome the handicap inherent in the earlier 2D-based technology. The latest toolsoffer them a panoramic view, which is a powerful ally for surgery. At the same time, the need to reorient to endoscopic anatomy has posed a challenge with surgeons having to move up a learning curve.In light of this, a series of training programmes has been offered to neurosurgeons, to make endoscopic surgery popular.

After being adapted for intraventricular surgery, the application has expanded into the realms of skull base surgery too, heralding an era of minimally invasive neurosurgery. Pituitary tumors are now being removed entirely using trans-nasal endoscopic surgery. This has now extended further to anterior skull base lesions, suprasellar lesions and clival lesions all the way up to foramen magnum and C V Junction. Endoscopy-assisted neurosurgery has become a valuable tool for visualizing the most invisible corners during mcroneurosurgery.

Neuroendoscopy became a part of the Indian neurosurgical armamentarium in the early 1990’s. Though it was introduced primarily for endoscopic 3rd ventriculostomy it soonbecame a part of cranial, ventricular, skull base and spinal neurosurgery. The number of centers and neurosurgeons routinely using endoscopy grew rapidly. As on today there are nearly 25 centers engaged in advanced neuro endoscopic work in India. Their programmes involve both lab-oriented skill stations and cadaveric labs, which offer continuous training to younger neurosurgeons.

A kickoff group of neurosurgeons composed of Dr Venkataramanaa N K, DrDeopujari, Dr. Suresh Shankhla, Dr. Chidambaram, Dr. Ashish Suri and Dr Manas Panigrahi was formed in 2006 to create awareness and academic programmes around neuroendoscopy. This evolved into the “Neuroendoscopy Study Group of India” in 2012. Since then the number of conferences, publications, workshops and training programmes has increased progressively. Currently, the group is conducting several annual programmes too.

This year the Indian Endoscopic Neurosurgeons will hold the biggest event in the neuro-endoscopy calendar, the World Federation of Neuro-endoscopy (WFNE) in Mumbai. This is a great opportunity for us to invite the world, showcase our work and interact with people of common interest. On this occasion and with the objective of commemorating the World Meet of Neuroendoscopy 2013, the Neuroendoscopy Study Group of India has decided to bring outa publication on “Neuroendoscopy in India.”

The 2nd Neuro Endoscopic Study Group of India Conference of India was held in Bangalore in June 2015 under the chairmanship of Dr. N K Venkataramanaa.

For more information on the World Federation of Neuro-endoscopy (WFNE) even in Mumbai click on this link

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