Initial Experience Using a High-Definition 3-Dimensional Exoscope System for Microneurosurgery

Abstract BACKGROUND The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal optics, ergonomics, and maneuverability. A recently developed extracorporeal telescope (“exoscope”) operative system combines...

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Published in:Operative neurosurgery (Hagerstown, Md.) Vol. 14; no. 4; pp. 395 - 401
Main Authors: Sack, Jayson, Steinberg, Jeffrey A, Rennert, Robert C, Hatefi, Dustin, Pannell, Jeffrey S, Levy, Michael, Khalessi, Alexander A
Format: Journal Article
Language:English
Published: United States Oxford University Press 01-04-2018
Wolters Kluwer Health, Inc
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Abstract Abstract BACKGROUND The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal optics, ergonomics, and maneuverability. A recently developed extracorporeal telescope (“exoscope”) operative system combines characteristics from both the operative microscope and endoscope and provides an affordable, portable, high-definition operative experience. Widespread use of exoscopes in neurosurgery has previously been limited by a lack of stereopsis with 2-dimensional(2-D) monitors. OBJECTIVE To assess the surgical potential of a novel, 3-D, high-definition (4K-HD) exoscope system. METHODS Assess dissection time and visualization of critical structures in a series of human cadaveric cranial neurosurgical approaches with the 3-D 4K-HD exoscope as compared to a standard operating microscope. RESULTS Dissection times and visualization of critical structures was comparable with the 3-D 4K-HD exoscope and a standard operating microscope. The low-profile exoscope nonetheless allowed for larger operative corridors, enhanced instrument maneuverability, and less obstruction in passing instrumentation. The large monitor also resulted in an immersive surgical experience, and gave multiple team members the same high-quality view as the primary operator. Finally, the exoscope possessed a more ergonomically favorable setup as compared to the traditional microscope, allowing the surgeon to be in a neutral position despite the operative angle. CONCLUSION The novel 3-D 4K-HD exoscope system possesses favorable optics, ergonomics, and maneuverability as compared to the traditional operating microscope, with the exoscope's shared surgical view possessing obvious educational and workflow advantages. Further clinical trials are justified to validate this initial cadaveric experience.
AbstractList Abstract BACKGROUND The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal optics, ergonomics, and maneuverability. A recently developed extracorporeal telescope (“exoscope”) operative system combines characteristics from both the operative microscope and endoscope and provides an affordable, portable, high-definition operative experience. Widespread use of exoscopes in neurosurgery has previously been limited by a lack of stereopsis with 2-dimensional(2-D) monitors. OBJECTIVE To assess the surgical potential of a novel, 3-D, high-definition (4K-HD) exoscope system. METHODS Assess dissection time and visualization of critical structures in a series of human cadaveric cranial neurosurgical approaches with the 3-D 4K-HD exoscope as compared to a standard operating microscope. RESULTS Dissection times and visualization of critical structures was comparable with the 3-D 4K-HD exoscope and a standard operating microscope. The low-profile exoscope nonetheless allowed for larger operative corridors, enhanced instrument maneuverability, and less obstruction in passing instrumentation. The large monitor also resulted in an immersive surgical experience, and gave multiple team members the same high-quality view as the primary operator. Finally, the exoscope possessed a more ergonomically favorable setup as compared to the traditional microscope, allowing the surgeon to be in a neutral position despite the operative angle. CONCLUSION The novel 3-D 4K-HD exoscope system possesses favorable optics, ergonomics, and maneuverability as compared to the traditional operating microscope, with the exoscope's shared surgical view possessing obvious educational and workflow advantages. Further clinical trials are justified to validate this initial cadaveric experience.
The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal optics, ergonomics, and maneuverability. A recently developed extracorporeal telescope ("exoscope") operative system combines characteristics from both the operative microscope and endoscope and provides an affordable, portable, high-definition operative experience. Widespread use of exoscopes in neurosurgery has previously been limited by a lack of stereopsis with 2-dimensional(2-D) monitors. To assess the surgical potential of a novel, 3-D, high-definition (4K-HD) exoscope system. Assess dissection time and visualization of critical structures in a series of human cadaveric cranial neurosurgical approaches with the 3-D 4K-HD exoscope as compared to a standard operating microscope. Dissection times and visualization of critical structures was comparable with the 3-D 4K-HD exoscope and a standard operating microscope. The low-profile exoscope nonetheless allowed for larger operative corridors, enhanced instrument maneuverability, and less obstruction in passing instrumentation. The large monitor also resulted in an immersive surgical experience, and gave multiple team members the same high-quality view as the primary operator. Finally, the exoscope possessed a more ergonomically favorable setup as compared to the traditional microscope, allowing the surgeon to be in a neutral position despite the operative angle. The novel 3-D 4K-HD exoscope system possesses favorable optics, ergonomics, and maneuverability as compared to the traditional operating microscope, with the exoscope's shared surgical view possessing obvious educational and workflow advantages. Further clinical trials are justified to validate this initial cadaveric experience.
BACKGROUNDThe operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal optics, ergonomics, and maneuverability. A recently developed extracorporeal telescope ("exoscope") operative system combines characteristics from both the operative microscope and endoscope and provides an affordable, portable, high-definition operative experience. Widespread use of exoscopes in neurosurgery has previously been limited by a lack of stereopsis with 2-dimensional(2-D) monitors. OBJECTIVETo assess the surgical potential of a novel, 3-D, high-definition (4K-HD) exoscope system. METHODSAssess dissection time and visualization of critical structures in a series of human cadaveric cranial neurosurgical approaches with the 3-D 4K-HD exoscope as compared to a standard operating microscope. RESULTSDissection times and visualization of critical structures was comparable with the 3-D 4K-HD exoscope and a standard operating microscope. The low-profile exoscope nonetheless allowed for larger operative corridors, enhanced instrument maneuverability, and less obstruction in passing instrumentation. The large monitor also resulted in an immersive surgical experience, and gave multiple team members the same high-quality view as the primary operator. Finally, the exoscope possessed a more ergonomically favorable setup as compared to the traditional microscope, allowing the surgeon to be in a neutral position despite the operative angle. CONCLUSIONThe novel 3-D 4K-HD exoscope system possesses favorable optics, ergonomics, and maneuverability as compared to the traditional operating microscope, with the exoscope's shared surgical view possessing obvious educational and workflow advantages. Further clinical trials are justified to validate this initial cadaveric experience.
BACKGROUND The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal optics, ergonomics, and maneuverability. A recently developed extracorporeal telescope (“exoscope”) operative system combines characteristics from both the operative microscope and endoscope and provides an affordable, portable, high-definition operative experience. Widespread use of exoscopes in neurosurgery has previously been limited by a lack of stereopsis with 2-dimensional(2-D) monitors. OBJECTIVE To assess the surgical potential of a novel, 3-D, high-definition (4K-HD) exoscope system. METHODS Assess dissection time and visualization of critical structures in a series of human cadaveric cranial neurosurgical approaches with the 3-D 4K-HD exoscope as compared to a standard operating microscope. RESULTS Dissection times and visualization of critical structures was comparable with the 3-D 4K-HD exoscope and a standard operating microscope. The low-profile exoscope nonetheless allowed for larger operative corridors, enhanced instrument maneuverability, and less obstruction in passing instrumentation. The large monitor also resulted in an immersive surgical experience, and gave multiple team members the same high-quality view as the primary operator. Finally, the exoscope possessed a more ergonomically favorable setup as compared to the traditional microscope, allowing the surgeon to be in a neutral position despite the operative angle. CONCLUSION The novel 3-D 4K-HD exoscope system possesses favorable optics, ergonomics, and maneuverability as compared to the traditional operating microscope, with the exoscope's shared surgical view possessing obvious educational and workflow advantages. Further clinical trials are justified to validate this initial cadaveric experience.
Author Levy, Michael
Rennert, Robert C
Khalessi, Alexander A
Steinberg, Jeffrey A
Hatefi, Dustin
Sack, Jayson
Pannell, Jeffrey S
Author_xml – sequence: 1
  givenname: Jayson
  surname: Sack
  fullname: Sack, Jayson
  organization: Department of Neurosurgery, University of California—San Diego, La Jolla, California
– sequence: 2
  givenname: Jeffrey A
  surname: Steinberg
  fullname: Steinberg, Jeffrey A
  organization: Department of Neurosurgery, University of California—San Diego, La Jolla, California
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  givenname: Robert C
  surname: Rennert
  fullname: Rennert, Robert C
  organization: Department of Neurosurgery, University of California—San Diego, La Jolla, California
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  givenname: Dustin
  surname: Hatefi
  fullname: Hatefi, Dustin
  organization: Department of Neurosurgery, University of California—San Diego, La Jolla, California
– sequence: 5
  givenname: Jeffrey S
  surname: Pannell
  fullname: Pannell, Jeffrey S
  organization: Department of Neurosurgery, University of California—San Diego, La Jolla, California
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  givenname: Michael
  surname: Levy
  fullname: Levy, Michael
  organization: Department of Neurosurgery, University of California—San Diego, La Jolla, California
– sequence: 7
  givenname: Alexander A
  surname: Khalessi
  fullname: Khalessi, Alexander A
  email: akhalessi@ucsd.edu
  organization: Department of Neurosurgery, University of California—San Diego, La Jolla, California
BackLink https://www.ncbi.nlm.nih.gov/pubmed/29106670$$D View this record in MEDLINE/PubMed
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Keywords Exoscope
Operating microscope
Stereopsis
Microneurosurgery
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Snippet Abstract BACKGROUND The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs...
The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal...
BACKGROUND The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and...
BACKGROUNDThe operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and...
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StartPage 395
SubjectTerms Neurosurgery
Title Initial Experience Using a High-Definition 3-Dimensional Exoscope System for Microneurosurgery
URI https://www.ncbi.nlm.nih.gov/pubmed/29106670
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Volume 14
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