Overview
This lecture covers the differences between microscopy and endoscopy in neurosurgery, highlighting advantages and limitations of each, especially in minimally invasive procedures.
Microscopy in Neurosurgery
- Microscopy is standard and used in nearly all neurosurgery cases for over 30 years.
- Provides high-resolution, stereoscopic (3D) views of surgical fields.
- Light intensity decreases in narrow or deep surgical corridors during minimally invasive surgeries.
- Surgeons work within the light beam, which can further reduce visibility if their hands block the light.
- Only structures directly in front of the lens are visualized.
Endoscopy in Neurosurgery
- Endoscopes provide a panoramic, close-up view, especially useful in deep or narrow surgical areas.
- The light source of the endoscope can be brought directly to the structure of interest.
- Angled optics (e.g., 30-degree endoscopes) allow visualization around corners or behind structures.
- Endoscopy enhances illumination and visualization in minimally invasive and open surgeries.
Comparison and Uses
- Microscopy is well-established and essential for basic visualization in neurosurgery.
- Endoscopy is increasingly important as surgical approaches become more minimally invasive.
- Endoscopy can serve as an adjunct or even as a primary tool, especially where traditional microscopy is limited.
Key Terms & Definitions
- Microscopy — the use of a microscope to provide a magnified, stereoscopic view during surgery.
- Endoscopy — the use of a slender instrument with a camera and light source to view inside the body.
- Stereoscopic View — a three-dimensional visual perspective provided by two optical paths.
- Angled Optics — lenses in endoscopes that allow visualization at angles, not just straight ahead.
Action Items / Next Steps
- Review diagrams comparing microscopic and endoscopic views in surgical fields.
- Familiarize yourself with the function and handling of both microscopes and endoscopes in neurosurgery.