34Development of innovative neurosurgery command of neuroendoscope –towards less invasive surgery–Neuroendoscopic SurgeryNeuroendoscopic Surgery（（Chief: Senior Assistant Prof. Toshihiro OgiwaraChief: Senior Assistant Prof. Toshihiro Ogiwara））NeurosurgerySummary of ActivityConventional 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 neurosur-gery, which is able to treat deep lesions, such as skull base and intraventricular lesions, is epoch-making. The Shinshu NeuroEndoscopic Team (SNET) is en-gaged 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. ・Research on neuroendoscopic surgery using robotics technology ・Study on repair method for CSF leak following endoscopic skull base surgery ・Development of new surgical device in endoscopic neurosurgery In the recent trend that less invasiveness is emphasized in the whole medical community, the scope of minimally invasive neurosendoscopic surgery is also enlarged. As further research progresses and the development of endoscope built-in robot, we are confident that in the near future the beginning of robotic neurosurgery era will come.Neuroendoscopic surgery is full of dreams and hope. We believe that by acquiring knowl-edge and skills through research in the field of neuroendoscopic surgery which will definitely develop in the future, we will be able to play an active role in the future. The possibilities after graduation are infinite.Research subjectOutlook for researchOutlook for students after graduationDevelopment of the innovative endoscopic neurosurgery command of robotic technol-ogy for less invasiveness (image gure)Various surgical devices for endoscopic neurosurgeryEndoscopic neurosurgery allows ma-nipulation in deep brain region.New aneurysm treatment without craniotomyEndovascular Treatment Endovascular Treatment （（Chief: Associate Prof. Jun-ichi KoyamaChief: Associate Prof. Jun-ichi Koyama））NeurosurgerySummary of ActivityBefore clinical use of MRI, the cerebral aneurysm was treated only after devel-oping subarachnoid hemorrhage by its rupture. However, due to recent improve-ments 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 emboli-zation without craniotomy (Fig. 1B). We are developing a new coil and also treat-ing cerebral aneurysms without even using coil for safer treatment.・Development of new coil・New treatment without coil (Flow diverter treatment)Conventional coil has a circular tube shape with the same diameter, but we are developing a new coil (Wavy coil) with dual diameters (Fig. 2). This coil has unique characteristics, and it is expected to improve the safety and curability of cerebral aneurysm treatment. A new cere-bral aneurysm treatment (flow diverter treatment) without coil has begun in the world (Fig. 3). Since the flow diverter has a high efficacy on a large aneurysm, we expect this treatment will provide great benefit to many patients.Catheter treatment in Japan is in a high level, but innovation in catheter treatment is pro-gressing rapidly in the world. After graduation, you could be active in the catheter treatment, and let this treatment advance. Even in the development of medical instruments, Japanese high technical strength will boost you.Research subjectOutlook for researchOutlook for students after graduationFigure 3 ’Flow diverter system’A: large aneurysm (circle of dotted line), B: ow diverter placement （black arrows), C: Aneurysm will shrinkFigure 1 A: clipping surgeryB: coil embolizationFigure 2 A: conventional coilFigure 2 A: conventional coilB: Wavy coil newly developmentB: Wavy coil newly development ClipClipCoilCoil
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