The VITOM® exoscope in oculoplastic surgery: the 5 year Coventry experience

BACKGROUND: Intraoperative imaging is a desirable tool in oculoplastic surgery; however, there are few modalities which allow surgeons to capture and edit the images in real time without compromising the sterility of the surgical field. We describe the set-up of the VITOM® exoscope system based on our 5 years’ experience of using it as an effective intraoperative video imaging and teaching modality for extraocular surgery. METHODS: The VITOM® is a specially designed exoscope mounted onto a versatile mechanical arm. It is attached to a high definition (HD) digital camera displayed on the HD video monitor of a standard endoscopy stack. This technology has been utilised in other surgical subspecialties, but there is no documented use within extraocular surgery. RESULTS: The exoscope was simple to set-up and allowed real-time recording and editing with an HD image display system. The theatre team were able to view the precise surgical steps, contributing to improved theatre flow. Trainees reported that the VITOM® images significantly improved their visualisation and understanding of key surgical anatomy and steps. CONCLUSIONS: Our experience showed that the VITOM® exoscope is an excellent intraoperative video imaging and teaching aid, as it allows real-time capture and editing of open surgery and seems to improve theatre flow. With newer models using 3D stereoscopic vision, it could be further evaluated as a heads-up viewing system within extraocular and oculoplastic surgery.