Scholars@Duke
Patrick James Codd

Patrick James Codd

Associate Professor of Neurosurgery
Neurosurgery
patrick.codd@duke.edu
200 Trent Dr, Durham, NC 27710
303 Research Drive, Box 3050, Durham, NC 27710

Selected Publications

Tendon-Actuated Concentric Tube Endonasal Robot (TACTER)

Journal Article Journal of Medical Robotics Research · December 1, 2025 Endoscopic endonasal approaches (EEA) have become more prevalent for minimally invasive skull base and sinus surgeries. However, rigid scopes and tools significantly decrease the surgeon’s ability to operate in tight anatomical spaces and avoid critical st ... Full text Cite

Current state of intraoperative neuromonitoring of the facial nerve during skull base surgery: A systematic review.

Journal Article J Clin Neurosci · October 2025 Intraoperative neuromonitoring of the facial nerve (cranial nerve VII) is critical during skull base surgery due to the nerve's proximity to surgical pathologies and the significant morbidity associated with a facial nerve injury. Objective: This systemati ... Full text Link to item Cite

Intraoperative blink reflex monitoring during skull base surgery: a single-institution method.

Journal Article Neurosurg Focus · September 1, 2025 OBJECTIVE: Cranial nerve (CN) preservation remains a challenge for skull base neurosurgeons, and neurophysiological intraoperative monitoring presents many methods for CN identification and mapping. The blink reflex, which is the electrophysiological repre ... Full text Link to item Cite

Intraoperative brain tumor classification via laser-induced fluorescence spectroscopy and machine learning.

Journal Article J Neurosurg · August 1, 2025 OBJECTIVE: To optimize neurosurgical tumor resection, tissue types and borders must be appropriately identified. Authors of this study established the use of a nondestructive laser-based endogenous fluorescence spectroscopy device, "TumorID," to almost imm ... Full text Open Access Link to item Cite

Venous sinus stenting for patients with encephaloceles: illustrative cases.

Journal Article J Neurosurg Case Lessons · May 5, 2025 BACKGROUND: Idiopathic intracranial hypertension (IIH) and venous sinus stenosis have recently been implicated in the pathogenesis of encephaloceles. OBSERVATIONS: Here, the authors present 2 cases in which venous sinus stenting was crucial for symptom man ... Full text Link to item Cite

Patient-derived organoid model of olfactory ensheathing cell tumor.

Journal Article Int Forum Allergy Rhinol · February 2025 We developed a culture model of a human olfactory ensheathing cell tumor. Cultured organoids resemble normal ensheathing cells. Assays suggest that this model provides a tool for studying the roles of these glial cells in the maintenance of the peripheral ... Full text Link to item Cite

Portable Dual Sensor Large Area Visualization System for Robotic Laser Surgery

Conference International Symposium on Medical Robotics Ismr · January 1, 2025 Laser scalpels are precise, dexterous, and efficient tools for soft tissue surgeries. However, surgical lasers are hard to control manually, require experience, and are often incompatible with conventional intraoperative imaging sensors. Integrating compat ... Full text Cite

Sampling-Based Model Predictive Control for Volumetric Ablation in Robotic Laser Surgery

Conference Proceedings IEEE International Conference on Robotics and Automation · January 1, 2025 Laser-based surgical ablation relies heavily on surgeon involvement, restricting precision to the limits of human error and perception. The interaction between laser and tissue is governed by various laser parameters that control the laser irradiance on th ... Full text Cite

Machine learning approaches in non-contact autofluorescence spectrum classification.

Journal Article PLOS Digit Health · October 2024 Manual surgical resection of soft tissue sarcoma tissue can involve many challenges, including the critical need for precise determination of tumor boundary with normal tissue and limitations of current surgical instrumentation, in addition to standard ris ... Full text Link to item Cite

A blinded study using laser induced endogenous fluorescence spectroscopy to differentiate ex vivo spine tumor, healthy muscle, and healthy bone.

Journal Article Sci Rep · January 22, 2024 Ten patients undergoing surgical resection for spinal tumors were selected. Samples of tumor, muscle, and bone were resected, de-identified by the treating surgeon, and then scanned with the TumorID technology ex vivo. This study investigates whether Tumor ... Full text Open Access Link to item Cite

Safety and Feasibility of Steroid-Eluting Stent as a Bolster in Endoscopic Anterior Skull Base Reconstruction.

Journal Article Ann Otol Rhinol Laryngol · January 2024 BACKGROUND: With a rising incidence of cerebrospinal fluid (CSF) leaks, endoscopic endonasal CSF leak repair is increasingly performed. Current approaches utilize a variety of materials including free mucosal grafts and vascularized flaps, but post-op leak ... Full text Link to item Cite

An FBG-based Stiffness Estimation Sensor for In-vivo Diagnostics

Conference 2024 International Symposium on Medical Robotics Ismr 2024 · January 1, 2024 In-vivo tissue stiffness identification can be useful in pulmonary fibrosis diagnostics and minimally invasive tumor identification, among many other applications. In this work, we propose a palpation-based method for tissue stiffness estimation that uses ... Full text Cite

Use of Tympanostomy T-Tube for Endoscopic Endonasal Marsupialization of Small Rathke's Cleft Cysts: A Case Series.

Journal Article J Neurol Surg B Skull Base · August 2023 Objectives  This article describes a novel technique implementing the use of a tympanostomy t-tube to provide long-term marsupialization of small Rathke's cleft cysts (RCCs). Design  A retrospective review of electronic medical records was performed to col ... Full text Link to item Cite

Brain-Mimicking Phantom for Photoablation and Visualization.

Journal Article Int Symp Med Robot · April 2023 While the use of tissue-mimicking (TM) phantoms has been ubiquitous in surgical robotics, the translation of technology from laboratory experiments to equivalent intraoperative tissue conditions has been a challenge. The increasing use of lasers for surgic ... Full text Open Access Link to item Cite

N-mirror Robot System for Laser Surgery: A Simulation Study.

Conference Int Symp Med Robot · April 2023 Automated laser surgery with sensor fusion is an important problem in medical robotics since it requires precise control of mirrors used to steer the laser systems. The propagation of the laser beam should satisfy the geometric constraints of the surgical ... Full text Link to item Cite

Approaches to the Cerebellopontine Angle

Chapter · January 1, 2023 The cerebellopontine angle (CPA) is formed by the petrosal cerebellar surface, middle cerebellar peduncle, lateral pons, petrosal surface of the petrous bone, and clival portion of the occipital bone. While only accounting for 10–15% of intracranial tumors ... Full text Cite

Preoperative validation of edema-corrected tractography in neurosurgical practice: translating surgeon insights into novel software implementation.

Journal Article Front Neurol · 2023 BACKGROUND: Peritumoral edema alters diffusion anisotropy, resulting in false negatives in tractography reconstructions negatively impacting surgical decision-making. With supratotal resections tied to survival benefit in glioma patients, advanced diffusio ... Full text Link to item Cite

3D Laser-and-Tissue Agnostic Data-Driven Method for Robotic Laser Surgical Planning

Conference IEEE International Conference on Intelligent Robots and Systems · January 1, 2023 In robotic laser surgery, shape prediction of an one-shot ablation crater is an important problem for minimizing errant overcutting of healthy tissue during the course of pathological tissue resection and precise tumor removal. Since it is difficult to phy ... Full text Cite

Addressing Surgical Instrument Oversupply: A Focused Literature Review and Case-Study in Orthopedic Hand Surgery.

Journal Article Hand (N Y) · November 2022 BACKGROUND: Instrument oversupply drives cost in the operating room (OR). We review previously reported methodologies for surgical instrument reduction and report a pilot methodology for optimizing instrument supply via ethnographic instrument tracking of ... Full text Link to item Cite

Measuring intraoperative surgical instrument use with radio-frequency identification.

Journal Article JAMIA Open · April 2022 OBJECTIVE: Surgical instrument oversupply drives cost, confusion, and workload in the operating room. With an estimated 78%-87% of instruments being unused, many health systems have recognized the need for supply refinement. By manually recording instrumen ... Full text Link to item Cite

Creation of Non-Contact Device for Use in Metastatic Melanoma Margin Identification in ex vivo Mouse Brain.

Journal Article Proc SPIE Int Soc Opt Eng · 2022 Because contemporary intraoperative tumor detection modalities, such as intraoperative MRI, are not ubiquitously available and can disrupt surgical workflow, there is an imperative for an accessible diagnostic device that can meet the surgeon's needs in id ... Full text Open Access Link to item Cite

Radiofrequency Identification Track for Tray Optimization: An Instrument Utilization Pilot Study in Surgical Oncology.

Journal Article J Surg Res · August 2021 BACKGROUND: Surgical instrument tray reduction attempts to minimize intraoperative inefficiency and processing costs. Previous reduction methods relied on trained observers manually recording instrument use (i.e. human ethnography), and surgeon and/or staf ... Full text Link to item Cite

Touch-Point Detection Using Thermal Video With Applications to Prevent Indirect Virus Spread.

Journal Article IEEE J Transl Eng Health Med · 2021 Viral and bacterial pathogens can be transmitted through direct contact with contaminated surfaces. Efficient decontamination of contaminated surfaces could lead to decreased disease transmission, if optimized methods for detecting contaminated surfaces ca ... Full text Link to item Cite

Creation of an Automated Fluorescence Guided Tumor Ablation System.

Journal Article IEEE J Transl Eng Health Med · 2021 OBJECTIVE: Create a device that improves the identification and extent of resection at the interface between healthy and tumor tissue; ultimately, using this device would improve surgical outcomes for patients and increase survival. METHODS: We have create ... Full text Link to item Cite

Olfactory-Specific Quality of Life Outcomes after Endoscopic Endonasal Surgery of the Sella.

Journal Article Allergy Rhinol (Providence) · 2021 OBJECTIVE: To assess olfactory outcomes as measured by an olfactory-specific quality of life (QOL) questionnaire in patients undergoing EESBS for sellar lesions. DESIGN: Retrospective case series. SETTING: Tertiary academic medical center. PARTICIPANTS: In ... Full text Link to item Cite

StereoCNC: A Stereovision-guided Robotic Laser System.

Conference Rep U S · 2021 This paper proposes an End-to-End stereovision-guided laser surgery system that can conduct laser ablation on targets selected by human operators in the color image, referred as StereoCNC. Two digital cameras are integrated into a previously developed robo ... Full text Link to item Cite

A Novel Robotic System for Ultrasound-guided Peripheral Vascular Localization

Conference Proceedings IEEE International Conference on Robotics and Automation · January 1, 2021 In this paper, we present an autonomous RGBD and 2D ultrasound-guided robotic system for collecting 3D localized volumes of peripheral vessels. This compact design, with available commercial components, lends itself to platform utility throughout the human ... Full text Cite

Enhancing Reality: A Systematic Review of Augmented Reality in Neuronavigation and Education.

Journal Article World Neurosurg · July 2020 OBJECTIVE: Augmented reality (AR) is increasingly being explored as an adjunct to conventional neuronavigation systems. AR affords the ability to superimpose 3-dimensional images onto the real environment. A natural extension of this technology is to help ... Full text Link to item Cite

Targeting PD-L1 Initiates Effective Antitumor Immunity in a Murine Model of Cushing Disease.

Journal Article Clin Cancer Res · March 1, 2020 PURPOSE: Although pituitary adenoma is classified as benign, Cushing disease is associated with significant morbidity due to the numerous sequelae of elevated cortisol levels. Successful therapy for Cushing disease remains elusive due to high rates of trea ... Full text Link to item Cite

Characterization of photoablation versus incidence angle in soft tissue laser surgery: An experimental phantom study

Conference Progress in Biomedical Optics and Imaging Proceedings of SPIE · January 1, 2020 The removal of tissue with a laser scalpel is a complex process that is affected by the laser incidence angle on the surface of the tissue. Current models of laser ablation, however, do not account for the angle of incidence, assuming that it is always nor ... Full text Cite

Novel Application of Steroid Eluting Stent in Petrous Apex Cholesterol Granuloma.

Journal Article J Neurol Surg B Skull Base · October 2019 Objective  This study describes the safety and efficacy of mometasone furoate eluting stents in the management of petrous apex cholesterol granuloma approached through an endonasal endoscopic route and assesses the restenosis rate. Methods  Consecutive pat ... Full text Link to item Cite

Sinonasal Quality of Life Outcomes After Extended Endonasal Approaches to the Skull Base.

Journal Article J Neurol Surg B Skull Base · August 2019 Introduction  Endoscopic endonasal skull base surgery (EESBS) leads to significant alterations in sinonasal anatomy and physiology. However, there is limited data available on quality of life (QOL) outcomes following EESBS. Methods  A retrospective review ... Full text Link to item Cite

Ectopic cerebellar brain parenchyma

Journal Article Neurographics · August 1, 2019 Although ectopic cerebellar brain parenchyma is an extremely rare entity, it is a diagnosis that can be made based on MR imaging findings in select cases. Knowledge of ectopic cerebellar brain parenchyma and optimization of MR imaging sequence selection ca ... Full text Cite

A novel laser scalpel system for computer-assisted laser surgery

Conference Proceedings IEEE International Conference on Robotics and Automation · May 1, 2019 Laser scalpels are utilized across a variety of surgical and dermatological procedures due to their precision and non-contact nature. This paper presents a novel laser scalpel system for superficial laser therapy applications. The system integrates a RGB-D ... Full text Cite

Two Extraordinary Sellar Neuronal Tumors: Literature Review and Comparison of Clinicopathologic Features.

Journal Article Am J Clin Pathol · February 4, 2019 OBJECTIVES: The list of tumors involving the pituitary gland has been expanded to include a variety of neuronal and paraneuronal tumors in the 2017 World Health Organization tumor classification of endocrine organs. All the entities included in this catego ... Full text Link to item Cite

Creation of a non-contact, automated brain tumor detection device for use in brain tumor resection

Conference Progress in Biomedical Optics and Imaging Proceedings of SPIE · January 1, 2019 The ability to differentiate healthy and tumorous tissue is vital during the surgical removal of tumors. This ability is especially critical during neurosurgical tumor resection due to the risk associated with removing healthy brain tissue. In this paper, ... Full text Cite

Model for and analysis of intraoperative brain tumor boundary detection based on known spectral signatures of glioblastoma

Conference Progress in Biomedical Optics and Imaging Proceedings of SPIE · January 1, 2019 Intraoperative imaging of brain tumors using spectral signatures of tissue, based on injected fluorescent dye such as 5-ALA, has enabled surgeons to target residual malignant tissue near the boundaries of the tumor cavity where extent of resection is most ... Full text Cite

Automating neurosurgical tumor resection surgery: Volumetric laser ablation of cadaveric porcine brain with integrated surface mapping.

Journal Article Lasers Surg Med · December 2018 OBJECTIVE: Current surgical instruments for soft tissue resection including neurosurgical procedures rely on the accuracy and precision of the human operator and are fundamentally constrained by the human hand. Automated surgical action with the integratio ... Full text Link to item Cite

Masson's tumor of the pineal region: case report.

Journal Article J Neurosurg · June 2018 Intracranial intravascular papillary endothelial hyperplasia (IPEH), also referred to as Masson's tumor, is a condition that rarely occurs in the nervous system. IPEH most frequently occurs extracranially in the skin of the face, skull, neck, and trunk and ... Full text Link to item Cite

Evidence based diagnosis and management of chronic subdural hematoma: A review of the literature.

Journal Article J Clin Neurosci · April 2018 Chronic subdural hematomas are encapsulated blood collections within the dural border cells with characteristic outer "neomembranes". Affected patients are more often male and typically above the age of 70. Imaging shows crescentic layering of fluid in the ... Full text Link to item Cite

Transnasal Transsphenoidal Elevation of Optic Chiasm in Secondary Empty Sella Syndrome Following Prolactinoma Treatment.

Journal Article World Neurosurg · April 2018 BACKGROUND: Prolactinomas are typically treated nonsurgically with a dopamine agonist. Once the tumor shrinks, adjacent eloquent structures, such as the optic apparatus, can become skeletonized and herniate into the dilated parasellar space. CASE DESCRIPTI ... Full text Link to item Cite

Creation of an optically tunable, solid tissue phantom for use in cancer detection

Conference Progress in Biomedical Optics and Imaging Proceedings of SPIE · January 1, 2018 An optically tunable, solid tissue phantom was developed in order to aid in the verification and validation of non-destructive cancer detection technologies based on fluorescence spectroscopy. The solid tissue phantom contained agarose, hemoglobin, Intrali ... Full text Cite

Optimized path planning for soft tissue resection via laser vaporization

Conference Progress in Biomedical Optics and Imaging Proceedings of SPIE · January 1, 2018 Robotic and robotic-assisted surgeries are becoming more prevalent with the promise of improving surgical outcomes through increased precision, reduced operating times, and minimally invasive procedures. The handheld laser scalpel in neurosurgery has been ... Full text Cite

CSF in the ventricles of the brain behaves as a relay medium for arteriovenous pulse wave phase coupling.

Journal Article PLoS One · 2017 The ventricles of the brain remain perhaps the largest anatomic structure in the human body without established primary purpose, even though their existence has been known at least since described by Aristotle. We hypothesize that the ventricles help match ... Full text Link to item Cite

Pigmented Lesions of the Nervous System and the Neural Crest: Lessons From Embryology.

Journal Article Neurosurgery · January 2016 Neurosurgeons encounter a number of pigmented tumors of the central nervous system in a variety of locations, including primary central nervous system melanoma, blue nevus of the spinal cord, and melanotic schwannoma. When examined through the lens of embr ... Full text Link to item Cite

Initial Experience with High-Definition Camera-On-a-Chip Flexible Endoscopy for Intraventricular Neurosurgery.

Journal Article World Neurosurg · December 2015 OBJECTIVE: The usefulness of existing neuroendoscopes has been limited by either decreased range of motion or suboptimal image resolution. The flexible high-definition chip-camera endoscope has emerged as a potential solution to the shortcomings of availab ... Full text Link to item Cite

Ablation of porcine ligamentum flavum with Ho:YAG, q-switched Ho:YAG, and quadrupled Nd:YAG lasers.

Journal Article Lasers Surg Med · December 2015 BACKGROUND AND OBJECTIVES: Ligamentum flavum (LF) is a tough, rubbery connective tissue providing a portion of the ligamentous stability to the spinal column, and in its hypertrophied state forms a significant compressive pathology in degenerative spinal s ... Full text Link to item Cite

Ventriculoperitoneal shunt placement for POEMS syndrome.

Journal Article J Clin Neurosci · October 2015 We report a 41-year-old woman with a history of an uncomplicated spinal hemangioma resection, who developed acute onset sensory-motor polyneuropathy following influenza vaccine administration. With extensive workup she was diagnosed with POEMS syndrome wit ... Full text Link to item Cite

Rapid growth of an infectious intracranial aneurysm with catastrophic intracranial hemorrhage.

Journal Article J Clin Neurosci · March 2015 Infectious intracranial aneurysms are rare vascular lesions that classically occur in patients with infective endocarditis. We present a 49-year-old man with altered mental status and headache with rapid growth and rupture of an infectious intracranial ane ... Full text Link to item Cite

Concentric tube robot design and optimization based on task and anatomical constraints

Journal Article IEEE Transactions on Robotics · February 1, 2015 Concentric tube robots are catheter-sized continuum robots that are well suited for minimally invasive surgery inside confined body cavities. These robots are constructed from sets of precurved superelastic tubes and are capable of assuming complex 3-D cur ... Full text Cite

Three-dimensional brain surface visualization for epilepsy surgery of focal cortical dysplasia.

Journal Article J Clin Neurosci · July 2014 Focal cortical dysplasia (FCD) causes medically intractable seizures in 5-10% of adult epilepsy patients, but patients can become seizure free through surgical resection. The authors present the utility of three-dimensional surface visualization (3DSV) tha ... Full text Link to item Cite

Novel pressure-sensing skin for detecting impending tissue damage during neuroendoscopy: Laboratory investigation

Journal Article Journal of Neurosurgery Pediatrics · January 1, 2014 Object. Endoscopy plays an increasingly important role in minimally invasive neurosurgery. Visual feedback from the endoscope tip helps the surgeon prevent unwanted tissue contact. However, critical feedback regarding tissue deformation and trauma from pro ... Full text Cite

Endoscopic burr hole evacuation of an acute subdural hematoma.

Journal Article J Clin Neurosci · December 2013 Acute subdural hematoma evacuations frequently necessitate large craniotomies with extended operative times and high relative blood loss, which can lead to additional morbidity for the patient. While endoscopic minimally invasive approaches to chronic subd ... Full text Link to item Cite

Percutaneous steerable robotic tool delivery platform and metal microelectromechanical systems device for tissue manipulation and approximation: closure of patent foramen ovale in an animal model.

Journal Article Circ Cardiovasc Interv · August 2013 BACKGROUND: Beating-heart image-guided intracardiac interventions have been evolving rapidly. To extend the domain of catheter-based and transcardiac interventions into reconstructive surgery, a new robotic tool delivery platform and a tissue approximation ... Full text Link to item Cite

Kernohan-woltman notch phenomenon in acute subdural hematoma

Journal Article JAMA Neurology · January 1, 2013 Full text Cite

Robotic neuro-emdoscope with concentric tube augmentation

Journal Article IEEE International Conference on Intelligent Robots and Systems · December 1, 2012 Surgical robots are gaining favor in part due to their capacity to reach remote locations within the body. Continuum robots are especially well suited for accessing deep spaces such as cerebral ventricles within the brain. Due to the entry point constraint ... Full text Cite

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Journal Article Neurosurgery · April 1, 2012 Full text Cite

Diffuse central neurocytoma with craniospinal dissemination.

Journal Article J Clin Neurosci · January 2012 Central neurocytomas (CN) are benign central nervous system (CNS) tumors of neuroglial origin that represent 0.25 to 0.5% of all intracranial tumors in adults and an even smaller proportion of pediatric CNS tumors. These tumors characteristically occur in ... Full text Link to item Cite

Fourth ventricular neurocystercercosis presenting with acute hydrocephalus.

Journal Article J Clin Neurosci · June 2011 Neurocysticercosis is an infection caused by the larvae of the pork tapeworm Taenia solium. Parenchymal lesions commonly present with seizure activity and intraventricular lesions can cause hydrocephalus. A 33-year-old female patient presented in a comatos ... Full text Link to item Cite

Primary pediatric intraspinal sarcomas. Report of 3 cases.

Journal Article J Neurosurg Pediatr · September 2009 Sarcomas that arise from within the spinal canal are rare, particularly within the pediatric population. In general, these primary intraspinal sarcomas are highly aggressive, posing unique treatment challenges with respect to surgery and choice of adjuvant ... Full text Link to item Cite

Seckel syndrome and moyamoya.

Journal Article J Neurosurg Pediatr · April 2009 Seckel syndrome is an autosomal recessive disorder characterized by intrauterine and postnatal growth delay, microcephaly with mental retardation, and facial dysmorphisms including micrognathia, a recessed forehead, and a large beaked nose. Occurring in 1 ... Full text Link to item Cite

A recurrent cerebral arteriovenous malformation in an adult.

Journal Article J Neurosurg · September 2008 Arteriovenous malformations are generally considered to be cured following angiographically proven complete resection. However, rare instances of AVM recurrence despite negative findings on postoperative angiography have been reported in both children and ... Full text Link to item Cite

Loss of the mismatch repair protein MSH6 in human glioblastomas is associated with tumor progression during temozolomide treatment.

Journal Article Clin Cancer Res · April 1, 2007 PURPOSE: Glioblastomas are treated by surgical resection followed by radiotherapy [X-ray therapy (XRT)] and the alkylating chemotherapeutic agent temozolomide. Recently, inactivating mutations in the mismatch repair gene MSH6 were identified in two gliobla ... Full text Link to item Cite

Vertebra plana due to an aneurysmal bone cyst of the lumbar spine. Case report and review of the literature.

Journal Article J Neurosurg · December 2006 Aneurysmal bone cysts (ABCs) are benign, highly vascular osseous lesions characterized by cystic, blood-filled spaces surrounded by thin perimeters of expanded bone. Children and young adults are most often affected by spinal ABCs; more than 75% of patient ... Full text Link to item Cite