Researchers at the Affiliated Hospital of Jiangsu University have reported promising initial experiences with fully endoscopic techniques for clipping intracranial aneurysms, marking a significant advancement over traditional surgical methods.
This innovative approach was evaluated through a retrospective study of seven patients who underwent the procedure from January 2022 to July 2024. The study demonstrated its feasibility, safety, and effective outcomes, providing valuable insights for future clinical applications.
Conventional methods for treating aneurysms often involve open surgical clipping under microscopic guidance; this can carry risks of complications such as delayed bleeding or inability to adequately secure the aneurysm. The fully endoscopic technique allows for refined visualization of complex anatomical structures, drastically enhancing the surgeon's ability to perform precise operations.
During the study, all seven patients had their aneurysms successfully clipped, involving varied types, such as middle cerebral artery and anterior communicating artery aneurysms. Post-operative assessments confirmed complete occlusion of the aneurysms without any intraoperative complications, such as uncontrolled ruptures. Follow-ups indicated no post-operative mortality and significant recovery improvements, with six patients reporting excellent neurological outcomes.
Significantly, the study's authors emphasized the technique's benefits: "With the accumulation of experience and technological progress, the fully endoscopic technique could enable safe and effective clipping of an aneurysm, which provided valuable information for decision-making during surgery and shed new light on aneurysms clipping." Post-clipping inspections via endoscopy verified not only the successful placement of clips but also the preservation of important vessels adjacent to the aneurysms.
The methodology involved careful preoperative imaging and surgical planning, allowing for the selection of the most appropriate approach—be it pterional, interhemispheric, or supraorbital. The small incision made for the endoscopic insertion (about 3 cm) resulted in less brain retraction, which is known to lessen complications.
The technique used non-retraction surgery, which minimizes the risk during operations where the aneurysm may be vulnerable to rupture. The endoscope facilitated bimanual dissection and monitoring, ensuring each step was precisely visualized and executed. "Postclipping endoscopic inspection demonstrated complete occlusion of the aneurysm and preservation of parent, branching, and perforation vessels," the team noted, validating the robustness of this surgical approach.
This promising outcome is not merely anecdotal; it reflects growing recognition of the endoscope's role beyond adjunctive assistance to becoming central to the surgical technique itself. Traditionally, endoscopes have aided microsurgery but were seldom used as the sole visual tool for direct clipping of aneurysms.
The collective data from these seven cases offer compelling evidence supporting the continued exploration of fully endoscopic techniques across more cases and varied types of aneurysms. During the study, surgeons capitalized on superior illumination and visual angles, which provided additional anatomical details often obscured during standard procedures.
The encouraging results inspire optimism for the future of neurosurgery, indicating the potential for improved outcomes through the adoption of fully endoscopic approaches. "Our experience indicated the fully endoscopic techniques were safe and feasible for aneurysm clipping, which provided additional information and a good view of regional anatomical features with less manipulation," the researchers concluded, with confidence rooted firmly in the data collected.
With advancements such as these, the future looks bright for patients suffering from intracranial aneurysms, promising safer, less invasive treatment options with enhanced clinical outcomes.