Visualization of the Anterior Cerebral Artery Complex With a Continuously Variable-View Rigid Endoscope: New Options in Aneurysm Surgery

BACKGROUND: Neuroendoscopy is increasingly used as an adjunctive tool in intracranial aneurysm surgery. OBJECTIVE: To assess the versatility of a prototype continuously variable-view rigid endoscope in visualizing the anterior cerebral artery complex. METHODS: In 5 formaldehyde-fixed, arterially injected specimens, a standard frontolateral approach was used on both sides. After meticulous microsurgical dissection using this approach, the prototype of a multivariable rigid endoscope (EndoCAMeleon; Karl Storz GmbH & Co, Tuttlingen, Germany) was inserted. It is a rigid endoscope that is capable of changing its angle of view while remaining stationary and shape invariant. We inspected the anterior cerebral artery complex, using and testing the capabilities of the device. RESULTS: The continuously variable viewing mechanism enables the surgeon to adjust the field of view continuously and to optimize the visualization of the neurovascular structures. Because of the rigid tip combined with the continuously variable viewing mechanism, the need to move the endoscope within the surgical field was minimal. The field of view changes, but the tip itself hardly moves. The EndoCAMeleon was able to enhance both the visibility of the anterior cerebral artery complex and the accessibility of the A1 and A2 arterial walls to a range of approximately 270 degrees. CONCLUSION: The EndoCAMeleon enhances the visibility of the anterior cerebral artery complex and facilitates endoscope-assisted inspection, planning of clip application, and clip control.