Development of the innovative endoscopic neurosurgery command of robotic technology for less invasiveness (image figure)Various surgical devices for endoscopic neurosurgeryEndoscopic neurosurgery allows manipulation in deep brain region. Figure 1 A: clipping surgery B: coil embolizationFigure 2 A: clipping surgery B: coil embolizationFigure 3 ’Flow diverter system’ A: Large aneurysm (Circle of dotted line), B: flow diverter placement （black allow), C: Aneurysm will shrink信州大学医学部医学科発行年月：２０２４年７月発行：信州大学医学部27ClipCoilNeuroendoscopicSurgeryChief: Senior Lecture. Yu FujiiEndovascular Treatment Chief: Assoc. Prof. YoshikiHanaokaNeurosurgeryNeurosurgeryDevelopment of innovative neurosurgery command of neuroendoscope-towards less invasive surgery-Newaneurysm treatment without craniotomy Conventional microscopic neurosurgery may put a big burden on a patient. To resolve this invasiveness, the endoscopic neurosurgery recently has spread rapidly in substitution for a microscope. This less-invasive endoscopic neurosurgery, which is able to treat deep lesions, such as skull base and intraventricular lesions, is epoch-making. The Shinshu NeuroEndoscopic Team (SNET) is engaged in various researches on the theme of development of minimally invasive surgery using a neuroendoscope that has less burden on patients with various brain lesions. Before clinical use of MRI, the cerebral aneurysm was treated only after developing subarachnoid hemorrhage by its rupture. However, due to recent improvements in MRI resolution, cerebral aneurysms have been discovered before their rupture. Now, treatment has become possible before the rupture. There are two types of treatment: clipping under craniotomy (Fig. 1A) and catheter coil embolization without craniotomy (Fig. 1B). We are developing a new coil and also treating cerebral aneurysms without even using coil for safer treatment.Research subject?Research on neuroendoscopicsurgery using robotics technology?Study on repair method for CSF leak following endoscopic skull base surgery?Development of new surgical device in endoscopic neurosurgeryOutlook for researchIntherecenttrendthatlessinvasivenessisemphasizedinthewholemedicalcommunity,thescopeofminimallyinvasiveneurosendoscopicsurgeryisalsoenlarged.Asfurtherresearchprogressesandthedevelopmentofendoscopebuilt-inrobot,weareconfidentthatinthenearfuturethebeginningofroboticneurosurgeryerawillcome.Outlook for students after graduationNeuroendoscopicsurgeryisfullofdreamsandhope.Webelievethatbyacquiringknowledgeandskillsthroughresearchinthefieldofneuroendoscopicsurgerywhichwilldefinitelydevelopinthefuture,wewillbeabletoplayanactiveroleinthefuture.Thepossibilitiesaftergraduationareinfinity.Research subject?Development of new coil?New treatment without coil (Flow diverter treatment)Outlook for researchConventionalcoilhasacirculartubeshapewiththesamediameter,butwearedevelopinganewcoil(Wavycoil)withdualdiameters(Fig.2).Thiscoilhasuniquecharacteristics,anditisexpectedtoimprovethesafetyandcurabilityofcerebralaneurysmtreatment.Anewcerebralaneurysmtreatment(flowdivertertreatment)withoutcoilhasbegunintheworld(Fig.3).Sincetheflowdiverterhasahighefficacyonalargeaneurysm,weexpectthistreatmentwillprovidegreatbenefitOutlook for students after graduationCathetertreatmentinJapanisinahighlevel,butinnovationincathetertreatmentisprogressingrapidlyintheworld.Aftergraduation,youcouldbetreatment,andletthistreatmentadvance.Evenintheactiveinthecatheterdevelopmentofmedicalinstruments,Japanesehightechnicalstrengthwillboostyou.tomanypatients.
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