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

Authors

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

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