Artikel
What kind of neurosurgical procedures may be performed safely with 3D-HD-exoscope? First clinical experiences
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Autoren
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Akos Csokonay
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
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Benedikt Burkhardt
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
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Joachim Oertel
- Universitätsklinikum des Saarlandes, Klinik für Neurochirurgie, Homburg, Deutschland
| Veröffentlicht: | 18. Juni 2018 |
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Gliederung
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Objective: The 3D-exoscope transmits the operation field through camera to HD-monitor in 3D visualisation. Some experiences with exoscope have already been published but with 3D visualisation our experiences are lacking. The aim of this study was to collect the experiences and investigate what kind of neurosurgical surgeries could be performed safely with 3D-HD-exoscope.
Methods: There was analysed the type of procedures, type and size of craniotomies. After each surgery the surgeon, the assistant and the scrub nurse filled out a standardized questionnaire, which concentred on a subjective comparison to the operating microscope.
Results: A total of 31 surgeries was performed with 3D-HD-exoscope. In total 15 intracranial and 16 spinal procedures were performed. The smallest size of craniotomy was 27,6 x 14,5 mm, the smallest corticotomy was 11,2 x 10,3 mm and the deepest procedure war 67,7 mm. All of them was successfully performed with 3D-HD-exoscope. The handling of the camera was considered easier with exoscope than with microscope in 50 %, while handling of the control unit equal or easier in 93,76 %. The body posture was comfortable in 84,38 %. Five of six surgeons minded it is easy to learn the use of 3D-HD-exoscope. The anatomy and pathology were similarly or better recognizable in 87,5%. In 12,9% it was not possible to separate the pathological changes from the normal tissue and switch to microscope was needed. In 81,25% the illumination on the surface was considered better and in the depth worse in 59,38 %. The magnification in the depth was considered equal or better in 65,63%. The best results were seen in spinal procedures (12/16) and superficial intracranial tumor resections. In these spinal cases, cervical, thoracic, lumbar procedures were performed up to 3 level, with or without instrumentation. 50% of the assistants minded the assistancewas equal or easier. For scrub nurses, the set up was equal or easier in 58% of cases. In 75% the monitor position was not optimal for them.
Conclusion: Overall the handling and set up of 3D exoscope was considered easy. The illumination in the depth was considered insufficient in many cases. It seems to be optimal for spinal and superficial cranial surgeries.
