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J Neurol Surg A Cent Eur Neurosurg 2022; 83(06): 596-601
DOI: 10.1055/a-1768-4060
Technical Note

Experiences with a 3D4K Digital Exoscope System (ORBEYE) in a Wide Range of Neurosurgical Procedures

J. Göttsche‡   *
1   Department of Neurosurgery, Hamburg University Medical Center, Hamburg, Germany
,
A. Piffko‡   *
1   Department of Neurosurgery, Hamburg University Medical Center, Hamburg, Germany
,
T.F. Pantel
1   Department of Neurosurgery, Hamburg University Medical Center, Hamburg, Germany
,
M. Westphal
1   Department of Neurosurgery, Hamburg University Medical Center, Hamburg, Germany
,
J. Flitsch
1   Department of Neurosurgery, Hamburg University Medical Center, Hamburg, Germany
,
F.L. Ricklefs
1   Department of Neurosurgery, Hamburg University Medical Center, Hamburg, Germany
,
J. Regelsberger‡   *
2   Department of Neurosurgery, DIAKO Clinic Flensburg, Flensburg, Germany
,
L. Dührsen‡   *
1   Department of Neurosurgery, Hamburg University Medical Center, Hamburg, Germany
› Author Affiliations Funding None.
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Abstract

Background Exoscopic 3D4K video systems (EX) have recently been introduced as an alternative to conventional operating microscopes (OM). However, experience in handling and setup remains scarce. This study evaluated the practicability of exoscopic surgery in a wide range of procedures.

Material and Methods All EX operations performed between August 2018 and May 2020 were evaluated and compared with procedures using OM. A standardized questionnaire was used to evaluate surgeons' comfort, image quality (including fluorescence modes), and handling.

Results In all, 513 EX operations were performed during the investigated period. EX was generally rated as a valuable surgical tool. In particular, the digital 5-aminolevulinic acid (5-ALA) fluorescence and the comfort level of posture during surgery were stated to be superior to OM (100 and 83%, respectively).

Conclusion EX has been used for a significant number of neurosurgical procedures. While presuming that the technical methodology as such will not influence outcome of glioma surgery, proof of equipoise between different techniques expands the spectrum of surgical environments giving neurosurgeons a choice to work according to their preferred ergonomics.

Keywords

exoscope - technical innovations - operating microscope - survey

* These authors contributed equally to this work.


Previous Presentation

Parts of this work were presented at the annual meeting of the Section of Neurooncology of the German Society for Neurosurgery in Berlin/digitally in October 2020.


Parts of this work were presented at the annual meeting of the German Society for Neurosurgery (digitally) in June 2021.




Publication History

Received: 07 December 2021

Accepted: 07 February 2022

Accepted Manuscript online:
10 February 2022

Article published online:
27 June 2022

© 2022. Thieme. All rights reserved.

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