Surgeon's comfort: The ergonomics of a robotic exoscope using a head-mounted display

Abramović, Anto; Demetz, Matthias; Krigers, Aleksandrs; Bauer, Marlies; Lener, Sara; Pinggera, Daniel; Kerschbaumer, Johannes; Hartmann, Sébastian; Fritsch, Helga; Thomé, Claudius; Freyschlag, Christian F.

doi:10.1016/j.bas.2021.100855

Cited by 16 publications

(28 citation statements)

References 26 publications

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“…Some modern features include the lock-on-target and waypoints together with the footswitch which enables to place the camera and to return to saved targets of interest, even hands-free. These functions together with the mostly horizontal visual axis of the surgeon and assistant fixed on the monitors during surgery allow for more ergonomic posture and integration of the whole OR staff during the procedure 6,7 . Also the possibility of 3D vision for all OR staff members enables the utilization for education purposes 8,9 .…”

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confidence: 99%

Implementation of a three-dimensional (3D) robotic digital microscope (AEOS) in spinal procedures

Motov

Bonk

Krauss

et al. 2022

Sci Rep

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Three-dimensional exoscopes have been designed to overcome certain insufficiencies of operative microscopes. We aimed to explore the clinical use in various spinal surgeries. We performed surgery on patients with different spine entities in a neurosurgical department according to the current standard operating procedures over a 4-week period of time. The microsurgical part has been performed with Aesculap AEOS 3D microscope. Three neurosurgeons with different degree of surgical expertise completed a questionnaire with 43 items based on intraoperative handling and feasibility after the procedures. We collected and analyzed data from seventeen patients (35% male/65% female) with a median age of 70 years [CI 47–86] and median BMI of 25.8 kg/m2 [range 21–33]. We included a variety of spinal pathologies (10 degenerative, 4 tumor and 3 infectious cases) with different level of complexity. Regarding setup conflicts we observed issues with adjustment of the monitor position or while using additional equipment (e.g. fluoroscopy in fusion surgery) (p = 0.007/p = 0.001). However image resolution and sharpness as well as 3D-depth perception were completely satisfactory for all surgeons in all procedures. The utilization of the exoscopic arm was easy for 76.5% of the surgeons, and all of them declared a significant improvement of the surgical corridor. The 3D-exoscope implementation appears to achieve very satisfactory results in spinal procedures especially with minimally invasive approaches.

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mentioning

confidence: 99%

Implementation of a three-dimensional (3D) robotic digital microscope (AEOS) in spinal procedures

Motov

Bonk

Krauss

et al. 2022

Sci Rep

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“…Moreover, a notable benefit in terms of surgeon's ergonomics has been documented during a training experience. 22 In Table 4 we report a comparison between the main features of the RS, the exoscopes and the surgical microscopes.…”

Section: Discussionmentioning

confidence: 99%

“…in head and neck surgery during microvascular anastomosis. Moreover, a notable benefit in terms of surgeon's ergonomics has been documented during a training experience 22 …”

Section: Discussionmentioning

confidence: 99%

Minimally invasive microsurgical decompression of the lumbar spine using a novel robotised digital microscope: A preliminary experience

Rossini

Tropeano

Franzini

et al. 2023

Robotics Computer Surgery

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Background The operative microscope (OM) represents, to date, the standard for neurosurgical procedures. However, new technologies have been proposed during the latest years to overcome its limitations, from high‐quality exoscopes to complex robotised visualisation systems. We report our preliminary experience with a novel digital robotised microscope, the BHS RoboticScope (RS), for minimally invasive spinal surgery. Methods We employed the RS in five consecutive patients who underwent bilateral lumbar spine decompression through a monolateral approach. Patient outcomes, device technical characteristics and the surgeon's personal perspectives have been evaluated. Results No complications occurred. All procedures were concluded without switching to the microscope. Image quality, lightning, depth perception and freedom of movement were judged satisfactory as compared to the standard microscope. Conclusion The easy maneuverability and the high quality of pictures provided by the RS device improve the surgeon's comfort in deep fields, representing an effective option for minimally invasive spinal procedures.

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“…The ergonomic benefits of exoscopes have recently been studied and demonstrated through video motion analysis. 19…”

Section: Discussionmentioning

confidence: 99%

Technical Assessment of Microvascular Decompression for Trigeminal Neuralgia Using a 3-Dimensional Exoscope: A Case Series

Herta

Rössler

Dorfer

2022

Operative Neurosurgery

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BACKGROUND:Detailed anatomic visualization of the root entry zone of the trigeminal nerve is crucial to successfully perform microvascular decompression surgery (MVD) in patients with trigeminal neuralgia.OBJECTIVE:To determine advantages and disadvantages using a 3-dimensional (3D) exoscope for MVD surgery.METHODS:A 4K 3D exoscope (ORBEYE) was used by a single surgical team for MVD in a retrospective case series of 8 patients with trigeminal neuralgia in a tertiary center. Clinical and surgical data were collected, and advantages/disadvantages of using the exoscope for MVD were recorded after each surgery. Descriptive statistics were used to summarize the data.RESULTS:Adequate MVD of the trigeminal nerve root was possible in all patients by exclusively using the exoscope. It offered bright visualization of the cerebellopontine angle and the root entry zone of the trigeminal nerve that was comparable with a binocular operating microscope. The greatest advantages of the exoscope included good optical quality, the pronounced depth of field of the image for all observers, and its superior surgeon ergonomics. Disadvantages were revealed with overexposure at deep surgical sites and the lack of endoscope integration. In 6 patients, facial pain improved significantly after surgery (Barrow Neurological Institute pain intensity score I in 5 and III in 1 patient), whereas it did not in 2 patients (Barrow Neurological Institute score IV and V). No complications occurred.CONCLUSION:Utilization of a 3D exoscope for MVD is a safe and feasible procedure. Surgeons benefit from better ergonomics, excellent image quality, and an improved experience for observers.

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Surgeon's comfort: The ergonomics of a robotic exoscope using a head-mounted display

Cited by 16 publications

References 26 publications

Implementation of a three-dimensional (3D) robotic digital microscope (AEOS) in spinal procedures

Implementation of a three-dimensional (3D) robotic digital microscope (AEOS) in spinal procedures

Minimally invasive microsurgical decompression of the lumbar spine using a novel robotised digital microscope: A preliminary experience

Technical Assessment of Microvascular Decompression for Trigeminal Neuralgia Using a 3-Dimensional Exoscope: A Case Series

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