A Single-Center Experience with the Olympus ORBEYE 4K-3D Exoscope for Microsurgery of Complex Cranial Cases: Technical Nuances and Learning Curve

Giovanni Muscas; Francesca Battista; Andrea Boschi; Francesca Morone; Alessandro Della Puppa

doi:10.1055/s-0040-1719106

Journal of Neurological Surgery Part A: Central European Neurosurgery, Inhaltsverzeichnis

J Neurol Surg A Cent Eur Neurosurg 2021; 82(05): 484-489
DOI: 10.1055/s-0040-1719106

Technical Note

A Single-Center Experience with the Olympus ORBEYE 4K-3D Exoscope for Microsurgery of Complex Cranial Cases: Technical Nuances and Learning Curve

Giovanni Muscas

¹Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital and University of Florence, Florence, Italy

,

Francesca Battista

¹Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital and University of Florence, Florence, Italy

,

Andrea Boschi

¹Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital and University of Florence, Florence, Italy

,

Francesca Morone

¹Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital and University of Florence, Florence, Italy

,

Alessandro Della Puppa

¹Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital and University of Florence, Florence, Italy

› Institutsangaben

Abstract

Background The introduction of exoscopes in neurosurgery has been welcomed due to their maneuverability, ergonomics, and low-profile frame. 3D devices have further enabled a better stereoscopic visualization. Reports on their application, albeit more and more frequent, are still at their beginning stages. We present our experience with the Olympus ORBEYE 4K-3D exoscope for major cranial procedures. The strengths and weaknesses of the exoscope are presented, and the nuances associated with the learning curve are illustrated.

Methods Over 2 weeks, patients undergoing surgery for major cranial pathologies were offered to participate in this evaluation of the Olympus ORBEYE 4K-3D exoscope. Information on the use of the exoscope was collected to assess the features and struggles in the learning curve. A comparison with the operating microscope was made.

Results Fourteen patients with different intracranial pathologies were operated on with the exoscope. No surgery-related complications occurred. The microsurgical part was performed with the exoscope in six cases. The exoscope was used for 72.9% (±37.5%) of the whole microsurgical time vs. 27.1% (±37.5%) microscope time (p = 0.02).

Conclusion The Olympus ORBEYE 4K-3D exoscope represents a useful evolution of the operating microscope. It requires time to overcome potential difficulties, mostly related to previous motor schemes acquired with operating microscopes. Its features could represent the basis for a paradigm shift in microsurgery.

Keywords

exoscope - stereoscopic view - 4K-3D - microsurgery - neurosurgery

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Referenzen

References
1 Yaşargil MG, Curcic M, Abernathey CD. Microneurosurgery. Stuttgart: Thieme; 1996
2 Yaşargil MG. Microneurosurgery: principles, applications, and training. In: Sindou M. ed. Practical Handbook of Neurosurgery. Vienna: Springer; 2009: 3-30
3 Tew Jr, JM. M. Gazi Yaşargil: neurosurgery's man of the century. Neurosurgery 1999; 45 (05) 1010-1014
4 Murai Y, Sato S, Yui K. et al. Preliminary clinical microneurosurgical experience with the 4K3-dimensional microvideoscope (ORBEYE) System for microneurological surgery: observation study. Oper Neurosurg (Hagerstown) 2019; 16 (06) 707-716
5 Khalessi AA, Rahme R, Rennert RC. et al. First-in-man clinical experience using a high-definition 3-dimensional exoscope system for microneurosurgery. Oper Neurosurg (Hagerstown) 2019; 16 (06) 717-725
6 Mamelak AN, Nobuto T, Berci G. Initial clinical experience with a high-definition exoscope system for microneurosurgery. Neurosurgery 2010; 67 (02) 476-483
7 Belloch JP, Rovira V, Llácer JL, Riesgo PA, Cremades A. Fluorescence-guided surgery in high grade gliomas using an exoscope system. Acta Neurochir (Wien) 2014; 156 (04) 653-660
8 Muhammad S, Lehecka M, Niemelä M. Preliminary experience with a digital robotic exoscope in cranial and spinal surgery: a review of the Synaptive Modus V system. Acta Neurochir (Wien) 2019; 161 (10) 2175-2180
9 Rossini Z, Cardia A, Milani D, Lasio GB, Fornari M, D'Angelo V. VITOM 3D: preliminary experience in cranial surgery. World Neurosurg 2017; 107: 663-668
10 Oertel JM, Burkhardt BW. Vitom-3D for exoscopic neurosurgery: initial experience in cranial and spinal procedures. World Neurosurg 2017; 105: 153-162
11 Kwan K, Schneider JR, Du V. et al. Lessons learned using a high-definition 3-dimensional exoscope for spinal surgery. Oper Neurosurg (Hagerstown) 2019; 16 (05) 619-625
12 Nossek E, Schneider JR, Kwan K. et al. Technical aspects and operative nuances using a high-definition 3-dimensional exoscope for cerebral bypass Surgery. Oper Neurosurg (Hagerstown) 2019; 17 (02) 157-163
13 Ricciardi L, Chaichana KL, Cardia A. et al. The exoscope in neurosurgery: an innovative “point of view.” A systematic review of the technical, surgical and educational aspects. World Neurosurg 2019; 124: 136-144
14 Harput MV, Türe U. Commentary: first-in-man clinical experience using a high-definition 3-dimensional exoscope system for microneurosurgery. Oper Neurosurg (Hagerstown) 2019; 17 (02) E85-E87