Comparison of Conventional Microscopic and Exoscopic Experimental Bypass Anastomosis: A Technical Analysis

Hafez, Ahmad; Elsharkawy, Ahmed; Schwartz, Christoph; Muhammad, Sajjad; Laakso, Aki; Niemelä, Mika; Lehečka, Martin

doi:10.1016/j.wneu.2019.11.154

Cited by 24 publications

(43 citation statements)

References 26 publications

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“…No comparative studies were able to clarify the differences between these two technologies at this time. Two pre‐clinical studies have tried to compare the OE and the OM in performing microvascular anastomoses 21,22 . These studies demonstrated the non‐inferiority of the OE, but no clear differences and recommendations were drawn.…”

Section: Discussionmentioning

confidence: 99%

High‐definition three‐dimensional exoscope for head and neck reconstruction: Prospective analysis of 27 consecutive patients

et al. 2021

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Purpose To analyze the advantages and disadvantages of a three‐dimensional (3D) operating exoscope (OE) in head and neck free flap reconstruction. Methods Twenty‐seven consecutive patients (females: 8; mean age: 57.0) were included. After each procedure, both surgeon and nurse were asked to fill out a tailored questionnaire on a three‐point Likert scale including 12 items. Results All microvascular anastomoses were successfully completed, and no related complications were detected with a final free flap survival rate of 100% (mean follow‐up of 5.6 months, SD: 3.1 months). The ergonomics, the ease of use, and the possibility to share the view among all the OR members were the best‐rated items by the surgeons, while the luminance of the surgical field and the eye strain determined by the 3D glasses can still be improved. Conclusion Further comparative clinical studies are needed to clarify its real value in substitution to a conventional operating microscope.

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Section: Discussionmentioning

confidence: 99%

High‐definition three‐dimensional exoscope for head and neck reconstruction: Prospective analysis of 27 consecutive patients

et al. 2021

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“…Finally, in addition to providing safe and effective decompression, intraoperative High‐Definition 3‐Dimensional Exoscope is also beneficial to the surgeon. After proper adjustment, the surgeon and assistant can operate at the same level, avoiding long‐term damage to the surgeon by lowering their head, which is reduces the risk of injury to the neck and lumbar vertebrae 24 . Moreover, the High‐Definition 3‐Dimensional Exoscope has the function of video and image preservation, which is convenient for data preservation, teaching demonstration and academic communication.…”

Section: Discussionmentioning

confidence: 99%

Anterior Cervical Discectomy and Fusion Combined with Foraminotomy Assisted by High‐Definition 3‐Dimensional Exoscope in the Treatment of Cervical Spondylotic Radiculopathy Secondary to Bony Foraminal Stenosis

Bai

Wang

et al. 2021

Orthopaedic Surgery

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Objective: To evaluate the outcomes of cervical spondylotic radiculopathy secondary to bony foraminal stenosis treated with anterior cervical discectomy and fusion (ACDF) combined with anterior cervical foraminotomy (ACF) assisted by High-Definition 3-Dimensional Exoscope. Methods:In this retrospective study, a total of 19 consecutive patients (12 males and seven females, with an average of 49.2 years, range from 40 to 59 years) with spondylotic radiculopathy caused by bony foraminal stenosis underwent ACDF combined with ACF assisted by High-Definition 3-Dimensional Exoscope in our hospital between January 2019 and December 2019 were included in this study. All patients signed the consent form before the surgery. The patient baseline information such as gender, age, body mass index (BMI), surgery time, blood loss, hospital stay, lesion segment, side, follow-up time and postoperative complications were recorded. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and Visual Analogue Scale (VAS) were measured and compared before surgery, 1 months and final follow-up after surgery. The radiographic outcomes were evaluated using the C 2 -C 7 angel, disc height, foraminal height, superior diagonal distance, inferior diagonal distance, and foraminal area. Results:The involved levels included C 4 -C 5 (six cases), C 5 -C 6 (10 cases), C 6 -C 7 (three cases). The mean duration of the surgery, mean blood loss, mean hospital stay, and mean follow-up were 100 AE 11.10 min, 19.4 AE 7.05 mL, 7.1 AE 0.99 days, and 12.1 AE 2.25 months, respectively. The average preoperative JOA score was 11.9 AE 1.31, then improved to 15.7 AE 0.73 (t = À13.45, P < 0.001) and 16.2 AE 0.74 (t = À14.39, P < 0.001) at 1 month after operation and at last follow-up, respectively. The average preoperative NDI score was 27.3 AE 3.36, then decreased to 5.1 AE 1.79 (t = 20.63, P < 0.001) and 4.5 AE 1.21 (t = 25.53, P < 0.001) 1 month after operation and at last followup, respectively. The average preoperative VAS score was 6.7 AE 0.93, then decreased to 2.4 AE 0.69 (t = 15.05, P < 0.001) and 1.9 AE 0.78 (t = 16.40, P < 0.001) 1 month after operation and at last follow-up, respectively. As compared with the condition before surgery, there was a significant improvement in the C 2 -C 7 angel, disc height, foraminal height, and foraminal area (P < 0.05). None of the patients developed postoperative vascular injury, nerve injury, loosening and rupture of the internal fixation, displacement of interbody fusion cage, and pseudarthrosis. Conclusion:ACDF combined with ACF assisted by High-Definition 3-Dimensional Exoscope is effective and safe for the treatment of CSR caused by secondary to bony foraminal stenosis.

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“…3D digital microscopy is an asset to surgeons in non-reconstructive specialties because of its similar operative method with laparoscopy and the switch from microscope to exoscope with good quality outcome can be achieved in relatively short practice time. 13…”

Section: Bene Ts Of Our Approachmentioning

confidence: 99%

The Use And Benefits of 3D Digital Microscope In Hepatic Artery Reconstruction During Living Donor Liver Transplant

Lin

Hung

et al. 2021

Preprint

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Background: To compare the intraoperative process of hepatic artery anastomosis using conventional microscope and novel 3D digital microscope and to share our institute’s experience for better surgical training.Method: A retrospective cohort study with 46 hepatic artery reconstructions in living donor liver transplant patients via operational microscope (Control group) and 3D digital microscope Mitaka Kestrel View II (Study group). We then discuss and share our institution’s experience to improve surgical training. Results: Both operation instruments provide effective and comparable results. There was no statistical significance regarding operational objective results between conventional microscope and exoscope. Both instruments have no hepatic artery size limit, and both have complete vessel patency rate. Conclusions: There was no statistical differences regarding hepatic artery anastomosis between microscope and exoscope cohorts. However, exoscope provided better ergonomics in the operation room and lessen musculoskeletal strain, allowing surgeons to work in a more neutral and comfortable posture and allow first assistant to learn and assist more effectively. Using exoscope with micro-forceps and modified tie technique make artery reconstruction easier.

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Comparison of Conventional Microscopic and Exoscopic Experimental Bypass Anastomosis: A Technical Analysis

Cited by 24 publications

References 26 publications

High‐definition three‐dimensional exoscope for head and neck reconstruction: Prospective analysis of 27 consecutive patients

High‐definition three‐dimensional exoscope for head and neck reconstruction: Prospective analysis of 27 consecutive patients

Anterior Cervical Discectomy and Fusion Combined with Foraminotomy Assisted by High‐Definition 3‐Dimensional Exoscope in the Treatment of Cervical Spondylotic Radiculopathy Secondary to Bony Foraminal Stenosis

The Use And Benefits of 3D Digital Microscope In Hepatic Artery Reconstruction During Living Donor Liver Transplant

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