Beyond magnification and illumination: preliminary clinical experience with the 4K 3D ORBEYE™ exoscope and a literature review

Amoo, Michael; Henry, Jack; Javadpour, Mohsen

doi:10.1007/s00701-021-04838-8

Cited by 38 publications

(31 citation statements)

References 35 publications

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“…The rate of complications both intra- and postoperatively following exoscopic surgery was low. These findings are in line with previous studies [ 1 , 2 , 4 , 5 , 29 ].…”

Section: Discussionsupporting

confidence: 94%

“…The surgical satisfaction after having performed a procedure with the Aeos was high in 78.95% of all cases. This high level of contentment is comparable or even better than described in the current literature [ 1 , 5 , 6 , 28 ]. The rate of complications both intra- and postoperatively following exoscopic surgery was low.…”

Section: Discussionsupporting

confidence: 79%

“…The development and implementation of three-dimensional (3D) Exoscopes in the daily routine of neurosurgical practice is a matter of current debate [ 1 , 2 , 3 , 4 , 5 ]. Superior ergonomic comfort, improved image quality and magnification, increased accessibility of the surgical field and enhanced experience for residents during the surgical procedure are noted as the main advantages versus the use of the established standard operating microscope (OPMI) [ 1 , 6 , 7 , 8 ]. Instrument handling and intraoperative repositioning were highly rated by surgeons after having performed cranial and spinal procedures with an Exoscope [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a Novel Three-Dimensional Robotic Digital Microscope (Aeos) in Neurosurgery

Maurer

Prinz

Qasem

et al. 2021

Cancers

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Objective: Current literature debates the role of newly developed three-dimensional (3D) Exoscopes in the daily routine of neurosurgical practice. So far, only a small number of cadaver lab studies or case reports have examined the novel Aesculap Aeos Three-Dimensional Robotic Digital Microscope. This study aims to evaluate the grade of satisfaction and intraoperative handling of this novel system in neurosurgery. Methods: Nineteen neurosurgical procedures (12 cranial, 6 spinal and 1 peripheral nerve) performed over 9 weeks using the Aeos were analyzed. Ten neurosurgeons of varying levels of training were included after undergoing device instruction and training. Following every surgery, a questionnaire consisting of 43 items concerning intraoperative handling was completed. The questionnaires were analyzed using descriptive statistics. Results: No intraoperative complications occurred. Surgical satisfaction was ranked high (78.95%). In total, 84.21% evaluated surgical ergonomics as satisfactory, while 78.95% of the surgeons would like to use this system frequently. Image quality, independent working zoom function and depth of field were perceived as suboptimal by several neurosurgeons. Conclusion: The use of Aeos is feasible and safe in microsurgical procedures, and surgical satisfaction was ranked high among most neurosurgeons in our study. The system might offer advanced ergonomic conditions in comparison to conventional ocular-based microscopes.

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“…The rate of complications both intra- and postoperatively following exoscopic surgery was low. These findings are in line with previous studies [ 1 , 2 , 4 , 5 , 29 ].…”

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of a Novel Three-Dimensional Robotic Digital Microscope (Aeos) in Neurosurgery

Maurer

Prinz

Qasem

et al. 2021

Cancers

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“…One of the characteristics ascribed to exoscopes is that they are superior to a conventional OM in terms of ergonomic features both in brain and spine surgery [ 37 , 39 , 49 , 52 , 67 , 69 , 90 , 91 , 92 , 94 , 95 , 96 , 97 , 111 , 112 , 113 , 114 , 115 ], as the ergonomic handling and the ease of intraoperative positioning of the device were found to be beneficial. Second, 3D monitors lead to an improved involvement of the co-surgeon and the scrub nurse during the procedure, and although some authors were satisfied with the high-resolution 3D digital images during surgery [ 52 , 60 , 68 , 73 ], others were not satisfied with the visual quality.…”

Section: Discussionmentioning

confidence: 99%

The Exoscope in Neurosurgery: An Overview of the Current Literature of Intraoperative Use in Brain and Spine Surgery

Montemurro

Scerrati²,

Ricciardi

et al. 2021

JCM

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Background: Exoscopes are a safe and effective alternative or adjunct to the existing binocular surgical microscope for brain tumor, skull base surgery, aneurysm clipping and both cervical and lumbar complex spine surgery that probably will open a new era in the field of new tools and techniques in neurosurgery. Methods: A Pubmed and Ovid EMBASE search was performed to identify papers that include surgical experiences with the exoscope in neurosurgery. PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) were followed. Results: A total of 86 articles and 1711 cases were included and analyzed in this review. Among 86 papers included in this review 74 (86%) were published in the last 5 years. Out of 1711 surgical procedures, 1534 (89.6%) were performed in the operative room, whereas 177 (10.9%) were performed in the laboratory on cadavers. In more detail, 1251 (72.7%) were reported as brain surgeries, whereas 274 (16%) and 9 (0.5%) were reported as spine and peripheral nerve surgeries, respectively. Considering only the clinical series (40 studies and 1328 patients), the overall surgical complication rate was 2.6% during the use of the exoscope. These patients experienced complication profiles similar to those that underwent the same treatments with the OM. The overall switch incidence rate from exoscope to OM during surgery was 5.8%. Conclusions: The exoscope seems to be a safe alternative compared to an operative microscope for the most common brain and spinal procedures, with several advantages that have been reached, such as an easier simplicity of use and a better 3D vision and magnification of the surgical field. Moreover, it offers the opportunity of better interaction with other members of the surgical staff. All these points set the first step for subsequent and short-term changes in the field of neurosurgery and offer new educational possibilities for young neurosurgery and medical students.

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“…We searched PubMed for reports on preliminary studies on exoscopic neurosurgery published since 2019 using the search terms “exoscope,” “microsurgery,” and “neurosurgery”. We found seven studies [ 1 , 21 , 22 , 23 , 24 , 25 , 26 ] with a mean number of cases of 21.4 (range, 18–29). Moreover, the number of EES included in this study is smaller than that of general exoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Clinical Surgical Experience with Temporary Simultaneous Use of an Endoscope during Exoscopic Neurosurgery: An Observational Study

Murai

Shirokane

Sato

et al. 2022

JCM

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The use of an endoscope in exoscopic transcranial neurosurgery for skull-base lesions has not yet been investigated. Thus, this study aimed to investigate the advantages, disadvantages, and safety of “simultaneous temporary use of an endoscope during exoscopic surgery” (exo-endoscopic surgery (EES)). Consecutive exo-endoscopic surgeries performed by experienced neurosurgeons and assistants were analyzed. Surgical complications and time were compared with previous consecutive microsurgeries performed by the same surgeon. A questionnaire survey was conducted on 16 neurosurgeons with experience in both “temporary simultaneous use of endoscope during microscopic surgery” (micro-endoscopic surgery (MES)) and EES. EES was performed in 18 of 76 exoscopic surgeries, including tumor removal (n = 10), aneurysm clipping (n = 5), and others (n = 3). There were no significant differences in operative time, anesthesia time, or complications from microsurgery by the same operator. According to the questionnaire survey results, compared with MES, EES had a wider field of view due to its lack of an eyepiece, was easier when loading and unloading instruments into and out of the surgical field, and was more suitable for the simultaneous observation of two fields of view. Overall, 79.2% of surgeons indicated that EES may be better suited than MES to simultaneously observe two fields of view.

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Beyond magnification and illumination: preliminary clinical experience with the 4K 3D ORBEYE™ exoscope and a literature review

Cited by 38 publications

References 35 publications

Evaluation of a Novel Three-Dimensional Robotic Digital Microscope (Aeos) in Neurosurgery

Evaluation of a Novel Three-Dimensional Robotic Digital Microscope (Aeos) in Neurosurgery

The Exoscope in Neurosurgery: An Overview of the Current Literature of Intraoperative Use in Brain and Spine Surgery

Preliminary Clinical Surgical Experience with Temporary Simultaneous Use of an Endoscope during Exoscopic Neurosurgery: An Observational Study

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