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First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery

The ideal visualization tools in microneurosurgery should provide magnification, illumination, wide fields of view, ergonomics, and unobstructed access to the surgical field. The operative microscope was the predominant innovation in modern neurosurgery. Recently, a high-definition three-dimensional...

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Autores principales: Beez, Thomas, Munoz-Bendix, Christopher, Beseoglu, Kerim, Steiger, Hans-Jakob, Ahmadi, Sebastian A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866118/
https://www.ncbi.nlm.nih.gov/pubmed/29581920
http://dx.doi.org/10.7759/cureus.2108
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author Beez, Thomas
Munoz-Bendix, Christopher
Beseoglu, Kerim
Steiger, Hans-Jakob
Ahmadi, Sebastian A
author_facet Beez, Thomas
Munoz-Bendix, Christopher
Beseoglu, Kerim
Steiger, Hans-Jakob
Ahmadi, Sebastian A
author_sort Beez, Thomas
collection PubMed
description The ideal visualization tools in microneurosurgery should provide magnification, illumination, wide fields of view, ergonomics, and unobstructed access to the surgical field. The operative microscope was the predominant innovation in modern neurosurgery. Recently, a high-definition three-dimensional (3D) exoscope was developed. We describe the first applications in pediatric neurosurgery. The VITOM 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany) was used in pediatric microneurosurgical operations, along with an OPMI PENTERO operative microscope (Carl Zeiss AG, Jena, Germany). Experiences were retrospectively evaluated with five-level Likert items regarding ease of preparation, image definition, magnification, illumination, field of view, ergonomics, accessibility of the surgical field, and general user-friendliness. Three operations were performed: supratentorial open biopsy in the supine position, infratentorial brain tumor resection in the park bench position, and myelomeningocele closure in the prone position. While preparation and image definition were rated equal for microscope and exoscope, the microscope’s field of view, illumination, and user-friendliness were considered superior, while the advantages of the exoscope were seen in ergonomics and the accessibility of the surgical field. No complications attributed to visualization mode occurred. In our experience, the VITOM 3D exoscope is an innovative visualization tool with advantages over the microscope in ergonomics and the accessibility of the surgical field. However, improvements were deemed necessary with regard to field of view, illumination, and user-friendliness. While the debate of a “perfect” visualization modality is influenced by personal preference, this novel visualization device has the potential to become a valuable tool in the neurosurgeon’s armamentarium.
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spelling pubmed-58661182018-03-26 First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery Beez, Thomas Munoz-Bendix, Christopher Beseoglu, Kerim Steiger, Hans-Jakob Ahmadi, Sebastian A Cureus Medical Education The ideal visualization tools in microneurosurgery should provide magnification, illumination, wide fields of view, ergonomics, and unobstructed access to the surgical field. The operative microscope was the predominant innovation in modern neurosurgery. Recently, a high-definition three-dimensional (3D) exoscope was developed. We describe the first applications in pediatric neurosurgery. The VITOM 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany) was used in pediatric microneurosurgical operations, along with an OPMI PENTERO operative microscope (Carl Zeiss AG, Jena, Germany). Experiences were retrospectively evaluated with five-level Likert items regarding ease of preparation, image definition, magnification, illumination, field of view, ergonomics, accessibility of the surgical field, and general user-friendliness. Three operations were performed: supratentorial open biopsy in the supine position, infratentorial brain tumor resection in the park bench position, and myelomeningocele closure in the prone position. While preparation and image definition were rated equal for microscope and exoscope, the microscope’s field of view, illumination, and user-friendliness were considered superior, while the advantages of the exoscope were seen in ergonomics and the accessibility of the surgical field. No complications attributed to visualization mode occurred. In our experience, the VITOM 3D exoscope is an innovative visualization tool with advantages over the microscope in ergonomics and the accessibility of the surgical field. However, improvements were deemed necessary with regard to field of view, illumination, and user-friendliness. While the debate of a “perfect” visualization modality is influenced by personal preference, this novel visualization device has the potential to become a valuable tool in the neurosurgeon’s armamentarium. Cureus 2018-01-24 /pmc/articles/PMC5866118/ /pubmed/29581920 http://dx.doi.org/10.7759/cureus.2108 Text en Copyright © 2018, Beez et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Medical Education
Beez, Thomas
Munoz-Bendix, Christopher
Beseoglu, Kerim
Steiger, Hans-Jakob
Ahmadi, Sebastian A
First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery
title First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery
title_full First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery
title_fullStr First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery
title_full_unstemmed First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery
title_short First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery
title_sort first clinical applications of a high-definition three-dimensional exoscope in pediatric neurosurgery
topic Medical Education
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866118/
https://www.ncbi.nlm.nih.gov/pubmed/29581920
http://dx.doi.org/10.7759/cureus.2108
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