Irrigation-Suction Straw Sheath System for a Rigid Endoscope during Endonasal Endoscopic Pituitary Surgery

Abstract

Objective: One of the most problematic conditions during endonasal endoscopic pituitary surgery is blurred endoscopic vision caused by blood or bone dust. To address this problem we used a new device, the irrigation-suction straw sheath system originally developed for endoscopic sinus surgery in rhinology, for the endoscopic pituitary surgery. Methods: The irrigation-suction straw system (K-endosheath; Koken Co., Tokyo, Japan) consists of a flattened disposable straw catheter which can be attached on a rigid endoscope. When the endoscope is inserted into the oblong catheter, two gaps remain on either side of the endoscope. Through each of these gaps irrigation and continuous suction are performed respectively. Results: Clear vision could be immediately obtained by pressing the button to release the irrigation water onto the endoscope’s front lens. Even targeted irrigation during drilling was possible. Above all, continuous suction was useful to clear the operative field of blood, smoke, or bone dust, ensuring the safety and uninterrupted progress of the procedure. Conclusion: This irrigation-suction system has proved to be very useful and easy to use for endonasal endoscopic pituitary surgery. Further development of such new devices and instruments specialized for endonasal endoscopic pituitary surgery will promote the increased use of this minimally invasive technique in neurosurgery.

Endonasal approach - endoscopy - irrigation system - pituitary surgery

References

• 1 Jho H D. Endoscopic pituitary surgery.  Pituitary. 1999;  2 139-154
• 2 Alfieri A. Endoscopic endonasal transsphenoidal approach to the sellar region: technical evolution of the methodology and refinement of a dedicated instrumentation.  J Neurosurg Sci. 1999;  43 85-92
• 3 Cappabianca P, Alfieri A, Thermes S, Buonamassa S, de Divitiis E. Instruments for endoscopic endonasal transsphenoidal surgery.  Neurosurgery. 1999;  45 392-396
• 4 Jho H D, Alfieri A. Endoscopic endonasal pituitary surgery: evolution of surgical technique and equipment in 150 operations.  Minim Invas Neurosurg. 2001;  44 1-12
• 5 Jarrahy R, Eby J B, Shahinian H K. A new powered endoscope holding arm for endoscopic surgery of the cranial base.  Minim Invas Neurosurg. 2002;  45 189-192
• 6 Kubota T, Yoshida K, Nakagawa T, Sato K. The new devices for endoscopic endonasal transsphenoidal surgery.  Child's Nerv Syst. 2003;  19 695-696 [abstract]
• 7 Other ENT products from Koken .K-endosheath. http:j//www.kokenmpc.co.jp/en/frame_product.html. 
• 8 Kennedy D W. Functional endoscopic sinus surgery: concepts, surgical indications, and instrumentation. In: Kennedy DW, Zinreich SJ, Bolger WE (eds). Diseases of the Sinuses: Diagnosis and Management. Hamilton, Ontario: BC Decker 2000: 197-210