Progressive Orbitotomy and Graduated Expansion of the Supraorbital Keyhole: A Comparison with Alternative Minimally Invasive Approaches to the Paraclinoid Region

Transorbital Surgical Corridor: An Anatomic Analysis of Ocular Globe Retraction and the Associated Exposure for the Transpalpebral Orbital Rim Preserving Endoscopic Orbitotomy (TORPEDO) Approach

“…While the DOF achieved without globe retraction is only 4.9°, 15 mm of medial retraction increases the axial DOF to 23.1°, which is similar to that seen by removing the lateral orbital rim. 19 Our results showed an average TORPEDO AOF of 345 mm 2 without eye retraction comparable with the 496 mm 2 found in previous studies comparing supraorbital craniotomies. 11,19 Tai et al 19 also showed that the ACP is fully visible with a supraorbital craniotomy and no globe retraction, while our study suggests that at least 5 to 10 mm of globe retraction is needed for a similar view and that this view is feasible and safe.…”

“…19 Our results showed an average TORPEDO AOF of 345 mm 2 without eye retraction comparable with the 496 mm 2 found in previous studies comparing supraorbital craniotomies. 11,19 Tai et al 19 also showed that the ACP is fully visible with a supraorbital craniotomy and no globe retraction, while our study suggests that at least 5 to 10 mm of globe retraction is needed for a similar view and that this view is feasible and safe. When comparing the AOF achieved by medial retraction with that achievable in the neutral position, 15 mm of retraction accomplished a near 7-fold increase AOF.…”

“…This system has been provided K1 clearance of new devices by the US Food and Drug Administration after extensive testing ensuring the object size has <1 mm accuracy. 11,19 For this experiment, the root of the ACP was chosen as the surgical target and a marker was placed here in VR at the junction of the optic strut. Using the VR system tools, the following measurements were collected after craniectomy: (1) AOF, (2) axial DOF, and (3) sagittal DOF.…”

Augmented-reality template guided transorbital approach for intradural tumors

“…This video demonstrates the technique of using augmented reality templates to guide the transorbital approach for intradural tumors. [1][2][3] For a "minimally invasive" approach to a deep-lying skull base lesion, the bone opening must be small yet provide adequate exposure to the surgical target. Surgical rehearsal in virtual reality (VR) can reveal the nuances of patient-specific anatomy and simultaneously generate navigation-integrated augmented reality templates to ensure precise surgical openings.…”

Next-Generation Simulation—Integrating Extended Reality Technology Into Medical Education

“…Beyond aiding in patient-specific surgical anatomy review, 3D reconstructions of high-quality medical scans are now being used with XR viewers to study new surgical approaches and population-wide differences in surgical anatomy, research that was previously limited by the availability of cadavers at most institutions (Tai et al, 2020b). A growing group of researchers are conducting high-powered retrospective reviews of patient-specific 3D models generated from large numbers of medical scans on hospital image servers to illustrate the ability of 3D reconstructions combined with XR visualizations to enhance the understanding of new surgical approaches and variations in surgical anatomy (Bendok et al, 2014;Jean et al, 2019;Tai et al, 2020a;Donofrio et al, 2020;Jean et al, 2021;Tai et al, 2021). The results are promising and highlight a new tool to research and understand surgical anatomy on a larger scale.…”