Pros and cons of using ORBEYE™ for microneurosurgery

Takahashi, Satoshi; Toda, Masahiro; Nishimoto, Masaaki; Ishihara, Eriko; Miwa, Takaki; Akiyama, Takahiro; Horiguchi, Takashi; Sasaki, Hidenao; Yoshida, Kazunari

doi:10.1016/j.clineuro.2018.09.010

Cited by 78 publications

(87 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The strengths of exoscopes are the wide field of view and deep focus with good illumination that minimize the need for repositioning and refocusing during the procedure. The published data on the VITOM-3D and ORBEYE exoscope systems report comparable results with the conventional microscope with good image quality and illumination in spine and cranial surgeries [1, 3–5, 7]. Even highly demanding procedures like brain arteriovenous malformation resection and aneurysm clipping have been successfully performed with a 3-dimensional exoscope system [2].…”

Section: Discussionmentioning

confidence: 99%

Preliminary experience with a digital robotic exoscope in cranial and spinal surgery: a review of the Synaptive Modus V system

2019

View full text Add to dashboard Cite

BackgroundThe microscope is the standard tool for microneurosurgery worldwide. However, the reduced illumination of the surgical field with the use of a conventional microscope during surgeries of deeply located pathologies remains unaddressed. Accordingly, different exoscope systems have recently been introduced in clinical practice. Here, we report our initial experience with the digital 2-dimensional Synaptive Modus V exoscope system in spinal and cranial surgery.MethodsDuring a 2-week period between 27 September to 11 October 2018, we used the Synaptive Modus V exoscope system and performed eight neurosurgical procedures including spine (n = 4) and cranial procedures (n = 4). Visual quality, depth perception, complications, switching to microscope comfort level of the surgeon, and learning curve during surgery were evaluated.ResultsA total of eight procedures were performed, namely, vestibular schwannoma (n = 1), skull base meningioma (n = 1), olfactory groove meningioma (n = 1), tentorial meningioma (n = 1), anterior cervical discectomy (n = 1), cervical laminectomy (n = 1), and lumbar disc herniation (n = 2). The overall results were comparable to the operative microscope with better visual quality and greater comfort for the surgeon.ConclusionThe Synaptive Modus V system is a safe tool to perform common spinal surgeries and intracranial tumor resection. Image quality is better than a microscope but with slightly less depth perception. Vigorous training in the laboratory may be helpful before clinical use.Electronic supplementary materialThe online version of this article (10.1007/s00701-019-03953-x) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Preliminary experience with a digital robotic exoscope in cranial and spinal surgery: a review of the Synaptive Modus V system

2019

View full text Add to dashboard Cite

show abstract

“…For many exoscopes directly base on the principles of endoscopy, they reproduce its inherent dissociation of working and viewing direction. In return, these machines promise to facilitate improvements in OR team visualization and surgical ergonomics [29]. Preclinical and clinical data is available for six exoscopic devices by different manufacturers (see Table 1), all of which benefit from recent technology improvements.…”

Section: Introductionmentioning

confidence: 99%

Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device

et al. 2020

View full text Add to dashboard Cite

Background Promoting a disruptive innovation in microsurgery, exoscopes promise alleviation of physical strain and improved image quality through digital visualization during microneurosurgical interventions. This study investigates the impact of a novel 3D4k hybrid exoscope (i.e., combining digital and optical visualization) on surgical performance and team workflow in preclinical and clinical neurosurgical settings. Methods A pre-clinical workshop setting has been developed to assess usability and implementability through skill-based scenarios (neurosurgical participants n = 12). An intraoperative exploration in head and spine surgery (n = 9) and a randomized clinical study comparing ocular and monitor mode in supratentorial brain tumor cases (n = 20) followed within 12 months. Setup, procedure, case characteristics, surgical performance, and user experience have been analyzed for both ocular group (OG) and monitor group (MG). Results Brain tumor cases using frontal, frontoparietal, or temporal approaches have been identified as favorable use cases for introducing exoscopic neurosurgery. Mean monitor distance and angle were 180 cm and 10°. Surgical ergonomics when sitting improved significantly in MG compared with OG (P = .03). Hand-eye coordination required familiarization in MG. Preclinical data showed a positive correlation between lateral camera inclination and impact on hand-eye coordination (rs = 0.756, P = .01). There was no significant added surgical time in MG. Image quality in current generation 3D4k monitors has been rated inferior to optic visualization yet awaits updates. Conclusions The hybrid exoscopic device can be integrated into established neurosurgical workflows. Currently, exoscopic interventions seem most suited for cranial tumor surgery in lesions that are not deep-seated. Ergonomics improve in monitor mode compared to conventional microsurgery.

show abstract

“…The usefulness of exoscopes, including ORBEYE (Olympus, Tokyo, Japan), which was recently introduced into neurosurgery, has been reported in several fields. [1][2][3][4] One of their merits is that they are superior to a conventional microscope in terms of ergonomic features. They do not limit the posture of the operator regardless of the angle of the operative visual axis, and we previously reported that ORBEYE facilitates ergonomic microsurgery with the angle of the operative visual axis approximately horizontal.…”

Section: Introductionmentioning

confidence: 99%

Retrosigmoid Approach in the Supine Position Using ORBEYE: A Consecutive Series of 14 Cases

Shimizu

Toyota

Nakagawa

et al. 2020

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

One of the merits of recently introduced exoscopes, including ORBEYE, is that they are superior to a conventional microscope in terms of ergonomic features. Taking advantage of it, the retrosigmoid approach can be performed in the supine position using ORBEYE. We report a consecutive series of 14 operations through the retrosigmoid approach in the supine position using ORBEYE. Fourteen consecutive patients who underwent surgery through the retrosigmoid approach for cerebellopontine (CP) angle lesions in the supine position using ORBEYE were targeted, and surgical outcomes and complications were examined. We evaluated the posture of the operator and the surgical field during this approach compared with those using a conventional microscope. In all 14 cases, all operative procedures were accomplished only using the ORBEYE. There were no operative complications due to this approach. Using ORBEYE, even when the angle of the operative visual axis was horizontal, the operators could manipulate in a comfortable posture. They were not forced to be in an uncomfortable posture that extended their arms, as is often the case with a conventional microscope. Therefore, they could use shorter surgical instruments. As the cerebellum shifted downward with gravity even using slight retraction during this approach, the working space of the surgical field was easily secured. Through this approach, the operators can perform stable microsurgery of CP angle lesions in a comfortable posture. This approach can reduce the burden on the operator and the patient, leading to a refined surgical procedure.

show abstract

Pros and cons of using ORBEYE™ for microneurosurgery

Cited by 78 publications

References 11 publications

Preliminary experience with a digital robotic exoscope in cranial and spinal surgery: a review of the Synaptive Modus V system

Preliminary experience with a digital robotic exoscope in cranial and spinal surgery: a review of the Synaptive Modus V system

Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device

Retrosigmoid Approach in the Supine Position Using ORBEYE: A Consecutive Series of 14 Cases

Contact Info

Product

Resources

About