In an attempt to improve visualization during aneurysm clipping we have incorporated a small endoscope into the aneurysm clip applicator so that the tips of the clip can be observed at all times. Below we report our initial experimental results with this instrument. These instruments have drawbacks, especially in their ability to evacuate clotted blood. We have attempted to rethink the design of these instruments and have developed a malleable endoscopic suction instrument. This has proved to be helpful in a variety of intracranial and intraspinal procedures.
Incorrect placement can lead to a failure of fusion or to significant neurologic morbidity.
Recently, techniques utilizing intraoperative monitoring and stereotaxis have been developed to achieve proper screw placement. While these techniques may be accurate, they are expensive and may require additional operating room personnel. We have developed an endoscopic pedicle probe for placement of pedicle screws that may overcome some of these limitations A small 1.2 millimeter endoscope was adapted to fit within a hollow pedicle probe. Irrigation was provided via a separate channel within the endoscope. Images from the probe were displayed both on a monitor screen and on a heads up display .