Article
4K3-dimensional microvideoscope (Orbeye) system for transsphenoidal pituitary surgery
4K-3D Mikrovideoskop (Orbeye) in der transsphenoidalen Hypophysenchirurgie
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Authors
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Roman Rotermund
- Universitätsklinikum Hamburg-Eppendorf, Neurochirurgie, Hamburg, Deutschland
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Jan Regelsberger
- Universitätsklinikum Hamburg-Eppendorf, Neurochirurgie, Hamburg, Deutschland
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Katharina Osterhage
- Universitätsklinikum Hamburg-Eppendorf, Neurochirurgie, Hamburg, Deutschland
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Jörg Flitsch
- Universitätsklinikum Hamburg-Eppendorf, Neurochirurgie, Hamburg, Deutschland
| Published: | June 26, 2020 |
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Outline
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Objective: Video microscopy represents a paradigm shift in microsurgery procedures. Multiple reports of experiences with different exoscope solutions in the neurosurgical field are present. In these first reports, this new technology was found not to be applicable for transsphenoidal pituitary surgery. As a specialized center for pituitary surgery with a high case load of more than 300 microscopic transsphenoidally operated patients per year, we tested the 3D 4K Orbeye (Olympus) as an attempt to evaluate the system to a greater extend for transsphenoidal pituitary surgery with taking a learning curve for this new way of performing surgery into account.
Methods: We report 67 clinical cases performed with the Orbeye (Olympus). The patients cohort is grouped into a first group with sporadic (7 patients, 06.02.-01.05.2019) and a second group with continuous use of the Orbeye (60 patients, 03.05-19.07.2019). An observational study with a questionnaire was conducted. The functionality of the Orbeye was evaluated based on the extend of the tumor resection. The surgeon’s impression was documented as benefits and disadvantages of the system.
Results: The patients presented with a wide range of pathologies, containing a majority of cases within the groups of non-functional pituitary adenomas (n=22), STH-adenomas (n=19), ACTH-adenomas (n=9). The patients had diverse clinical history with 30 % of patient being previously treated. No complications based on the usage of the new 3D 4K exoscope occurred intra- or postoperatively. Therefore there was no need to switch back to microscope in any of the cases. The Surgeons rated the Orbeye beneficial in instrument size, positioning, surgeon’s ergonomics, small learning curve, image resolution and high magnification possibility.
Conclusion: Video microscopy challenges the currently used microscopes for pituitary surgery. Due to its digital zoom-option as well the 3-D visualization and depth perception it seems an advancement in comparison to conventional microscopy. Regarding a comparison with endoscopy techniques, a comparative study is needed, however, the 3D 4K-Orbeye-exoscope combines benefits of both techniques.
