Advancement of Surgical Visualization Methods: Comparison Study Between Traditional Microscopic Surgery and a Novel Robotic Optoelectronic Visualization Tool for Spinal Surgery

Moisi, Marc; Hoang, Kevin; Tubbs, R. Shane; Page, Jeni; Fisahn, Christian; Paulson, David F.; Jeyamohan, Shiveindra; Delashaw, Johnny B.; Hanscom, David; Oskouian, Rod J.

doi:10.1016/j.wneu.2016.11.003

Cited by 43 publications

(40 citation statements)

References 12 publications

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“…Recently, the exoscope has been proposed as an alternative to the microscope in the field of neurosurgery. [1][2][3][4][5][26][27][28][29][30][31][32] One of the merits of exoscopes, including ORBEYE, is that they are superior to microscopes in terms of ergonomic features. The advantage of our method mainly depends on the excellence of the ergonomic operability.…”

Section: Discussionmentioning

confidence: 99%

Retrosigmoid Approach in the Supine Position Using ORBEYE: A Consecutive Series of 14 Cases

Shimizu

Toyota

Nakagawa

et al. 2020

Neurol. Med. Chir.(Tokyo)

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One of the merits of recently introduced exoscopes, including ORBEYE, is that they are superior to a conventional microscope in terms of ergonomic features. Taking advantage of it, the retrosigmoid approach can be performed in the supine position using ORBEYE. We report a consecutive series of 14 operations through the retrosigmoid approach in the supine position using ORBEYE. Fourteen consecutive patients who underwent surgery through the retrosigmoid approach for cerebellopontine (CP) angle lesions in the supine position using ORBEYE were targeted, and surgical outcomes and complications were examined. We evaluated the posture of the operator and the surgical field during this approach compared with those using a conventional microscope. In all 14 cases, all operative procedures were accomplished only using the ORBEYE. There were no operative complications due to this approach. Using ORBEYE, even when the angle of the operative visual axis was horizontal, the operators could manipulate in a comfortable posture. They were not forced to be in an uncomfortable posture that extended their arms, as is often the case with a conventional microscope. Therefore, they could use shorter surgical instruments. As the cerebellum shifted downward with gravity even using slight retraction during this approach, the working space of the surgical field was easily secured. Through this approach, the operators can perform stable microsurgery of CP angle lesions in a comfortable posture. This approach can reduce the burden on the operator and the patient, leading to a refined surgical procedure.

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Section: Discussionmentioning

confidence: 99%

Retrosigmoid Approach in the Supine Position Using ORBEYE: A Consecutive Series of 14 Cases

Shimizu

Toyota

Nakagawa

et al. 2020

Neurol. Med. Chir.(Tokyo)

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“…Since most pediatric neurosurgeons perform a larger percentage of neuroendoscopy cases, the learning curve and potential for acceptance might be higher in this subgroup. Observers benefit from watching the operation on a high-definition 3D screen, improving the teaching and learning experience [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery

Beez

Munoz-Bendix

Beseoglu

et al. 2018

Cureus

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The ideal visualization tools in microneurosurgery should provide magnification, illumination, wide fields of view, ergonomics, and unobstructed access to the surgical field. The operative microscope was the predominant innovation in modern neurosurgery. Recently, a high-definition three-dimensional (3D) exoscope was developed. We describe the first applications in pediatric neurosurgery. The VITOM 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany) was used in pediatric microneurosurgical operations, along with an OPMI PENTERO operative microscope (Carl Zeiss AG, Jena, Germany). Experiences were retrospectively evaluated with five-level Likert items regarding ease of preparation, image definition, magnification, illumination, field of view, ergonomics, accessibility of the surgical field, and general user-friendliness. Three operations were performed: supratentorial open biopsy in the supine position, infratentorial brain tumor resection in the park bench position, and myelomeningocele closure in the prone position. While preparation and image definition were rated equal for microscope and exoscope, the microscope’s field of view, illumination, and user-friendliness were considered superior, while the advantages of the exoscope were seen in ergonomics and the accessibility of the surgical field. No complications attributed to visualization mode occurred. In our experience, the VITOM 3D exoscope is an innovative visualization tool with advantages over the microscope in ergonomics and the accessibility of the surgical field. However, improvements were deemed necessary with regard to field of view, illumination, and user-friendliness. While the debate of a “perfect” visualization modality is influenced by personal preference, this novel visualization device has the potential to become a valuable tool in the neurosurgeon’s armamentarium.

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“…Several reports have documented the impact of stereoscopic depth perception, 3D perception, and proprioception in neurosurgery with the use of certain optical systems. Moisi et al described their initial experience with exoscopic optical systems in neurosurgery and commented on the operating microscope's inherent advantage due to stereoscopic depth perception, especially in deep‐seated surgery (ie, aneurysm clipping or skull base surgery) where deep drilling and delicate nerve and vessel manipulation is required . The lack of these optical cues has led to the hesitancy in the adoption of two‐dimensional (2D) exoscopic systems in neurosurgery.…”

Section: Discussionmentioning

confidence: 99%

Does the method of visualization impact the performance of a new surgical task in novice subjects?

Kassam

Chakravarthi

Epping

et al. 2020

Robotics Computer Surgery

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Introduction: Evolution of optical technology from two-dimensional to threedimensional (3D) systems has come with an associated loss of stereoscopy and 3D depth perception. This report compares performance of surgical tasks in unbiased subjects using these systems.Methods: Untrained subjects were randomized into two groups, robotically operated video optical telescopic-microscope (ROVOT) or surgical microscope (microscope).Subjects sutured and tied knots. Completion time, NASA-Task Load Index (TLX), and galvanic skin responses were analyzed.Results: Intergroup analysis of suture completion time indicated that microscope use was significantly faster compared to ROVOT, whether used first or second. Regardless of which methodology was used first, the second modality was faster, indicating a transfer effect. NASA-TLX indicated that mental, performance, effort, and frustration were all greater with ROVOT.Conclusion: Task completion time and perceived effort were greater with ROVOT.Task completion times improved with repetition regardless of visual modality.

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Advancement of Surgical Visualization Methods: Comparison Study Between Traditional Microscopic Surgery and a Novel Robotic Optoelectronic Visualization Tool for Spinal Surgery

Cited by 43 publications

References 12 publications

Retrosigmoid Approach in the Supine Position Using ORBEYE: A Consecutive Series of 14 Cases

Retrosigmoid Approach in the Supine Position Using ORBEYE: A Consecutive Series of 14 Cases

First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery

Does the method of visualization impact the performance of a new surgical task in novice subjects?

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