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Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device.

ABSTRACT: BACKGROUND:Promoting a disruptive innovation in microsurgery, exoscopes promise alleviation of physical strain and improved image quality through digital visualization during microneurosurgical interventions. This study investigates the impact of a novel 3D4k hybrid exoscope (i.e., combining digital and optical visualization) on surgical performance and team workflow in preclinical and clinical neurosurgical settings. METHODS:A pre-clinical workshop setting has been developed to assess usability and implementability through skill-based scenarios (neurosurgical participants n?=?12). An intraoperative exploration in head and spine surgery (n?=?9) and a randomized clinical study comparing ocular and monitor mode in supratentorial brain tumor cases (n?=?20) followed within 12 months. Setup, procedure, case characteristics, surgical performance, and user experience have been analyzed for both ocular group (OG) and monitor group (MG). RESULTS:Brain tumor cases using frontal, frontoparietal, or temporal approaches have been identified as favorable use cases for introducing exoscopic neurosurgery. Mean monitor distance and angle were 180 cm and 10°. Surgical ergonomics when sitting improved significantly in MG compared with OG (P?=?.03). Hand-eye coordination required familiarization in MG. Preclinical data showed a positive correlation between lateral camera inclination and impact on hand-eye coordination (rs?=?0.756, P?=?.01). There was no significant added surgical time in MG. Image quality in current generation 3D4k monitors has been rated inferior to optic visualization yet awaits updates. CONCLUSIONS:The hybrid exoscopic device can be integrated into established neurosurgical workflows. Currently, exoscopic interventions seem most suited for cranial tumor surgery in lesions that are not deep-seated. Ergonomics improve in monitor mode compared to conventional microsurgery.

SUBMITTER: Roethe AL

PROVIDER: S-EPMC7593287 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device.

Roethe Anna L AL Landgraf Philipp P Schröder Torsten T Misch Martin M Vajkoczy Peter P Picht Thomas T

Acta neurochirurgica 20200519 12

<h4>Background</h4>Promoting a disruptive innovation in microsurgery, exoscopes promise alleviation of physical strain and improved image quality through digital visualization during microneurosurgical interventions. This study investigates the impact of a novel 3D4k hybrid exoscope (i.e., combining digital and optical visualization) on surgical performance and team workflow in preclinical and clinical neurosurgical settings.<h4>Methods</h4>A pre-clinical workshop setting has been developed to a ...[more]

PMID: 32424568

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Dataset Information

Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device.

Publications

Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device.

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