Endoscopic-approach development for minimally invasive orbital surgery

Karen Joos M.D.; Rohan Shah; Jin Shen

doi:10.1117/12.702582

5 March 2007 Endoscopic-approach development for minimally invasive orbital surgery

Karen Joos M.D., Rohan Shah, Jin Shen

Proceedings Volume 6426, Ophthalmic Technologies XVII; 64261D (2007) https://doi.org/10.1117/12.702582
Event: SPIE BiOS, 2007, San Jose, California, United States

Abstract

Purpose: Orbital tumors and pseudotumor cerebri are sometimes treated with surgical approaches. Our previous studies suggest that potentially endoscopy may be useful for minimally invasive orbital surgery. This study proposed to improve the approach technique for accessing the posterior orbital space via endoscopy, as well as assess visibility improvements with CO₂ insufflation to posterior orbital tissues. Methods: An inferior transconjunctival approach accessed the posterior orbital space in non-survival pigs. Various guidance tubes were compared to assess ability to guide the endoscope to the posterior orbit with the greatest ease and visibility. FEL energy application (6.1 &mgr;m, 2.7 ± 0.5 mJ, 30 Hz, delivered via glass-hollow waveguide) was attempted via endoscopy. The effect of CO₂ gas insufflation was assessed by analyzing visibility of the stuctures before and after CO₂ application. Results: The posterior orbit was accessed via endoscopy in all except the first attempted eye. A beveled transparent butyrate tube provided the best guidance for the endoscope and an opaque metal tube provided the worst guidance. The optic nerve was encountered and FEL energy was applied with the butyrate tube in 8 orbits. Visibility was adequate without CO₂ insufflation, and did not improve with CO₂. Conclusions: The posterior orbit was successfully accessed using endoscopy. The optic nerve was exposed and treated with FEL energy. CO₂ insufflation did not further enhance visibility in this study. Application of endoscopy for posterior orbital procedures is feasible, but extreme surgical care is required and further study with human cadaveric eyes is needed.

Citation Download Citation

Karen Joos M.D., Rohan Shah, and Jin Shen "Endoscopic-approach development for minimally invasive orbital surgery", Proc. SPIE 6426, Ophthalmic Technologies XVII, 64261D (5 March 2007); https://doi.org/10.1117/12.702582

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