Endoneurosurgery: endoscopic intracranial surgery

Abstract

Sixty-five years ago the cerebral ventricles of a hydrocephalic child were first inspected in vivo by means of an endoscope. The pioneering surgeon was Espinasse of Chicago, and the instrument was a cystoscope designed for looking into the adult bladder. This instrument utilized the system of lenses designed by Nitze of Vienna in 1887 illuminated by a distally placed incandescent bulb which appears to have been applied to Nitze’s cystoscope by Newman of Glasgow only three years after Edison had devised the incandescent lamp in 1880. Espinasse’s adventure was described by Davis (L’Espinasse 1943) in the following terms: ‘The first attempt to remove a choroid plexus for hydrocephalus with which I am familiar was made by Dr V. L’Espinasse of Chicago. In 1910, L’Espinasse introduced a small cystoscope into the ventricle and fulgurated the plexus bilaterally in 2 infants. One of his patients died post operatively, and the second lived 5 years. The method was presented before a local medical society and was not otherwise recorded. ’