“…So far, the majority of reports have focused on the VITOM (Karl Storz, Tuttlingen, Germany), the Olympus ORBEYE (Olympus, Tokyo, Japan) and the Zeiss KINEVO (Carl Zeiss AG, Oberkochen, Germany) ( Table 1 ). Only a small number of experimental setups, a cadaver lab study or case reports referred to the utilization of the novel Aesculap Aeos Three-Dimensional Robotic Digital Microscope [ 10 , 12 , 13 ].…”
Objective: Current literature debates the role of newly developed three-dimensional (3D) Exoscopes in the daily routine of neurosurgical practice. So far, only a small number of cadaver lab studies or case reports have examined the novel Aesculap Aeos Three-Dimensional Robotic Digital Microscope. This study aims to evaluate the grade of satisfaction and intraoperative handling of this novel system in neurosurgery. Methods: Nineteen neurosurgical procedures (12 cranial, 6 spinal and 1 peripheral nerve) performed over 9 weeks using the Aeos were analyzed. Ten neurosurgeons of varying levels of training were included after undergoing device instruction and training. Following every surgery, a questionnaire consisting of 43 items concerning intraoperative handling was completed. The questionnaires were analyzed using descriptive statistics. Results: No intraoperative complications occurred. Surgical satisfaction was ranked high (78.95%). In total, 84.21% evaluated surgical ergonomics as satisfactory, while 78.95% of the surgeons would like to use this system frequently. Image quality, independent working zoom function and depth of field were perceived as suboptimal by several neurosurgeons. Conclusion: The use of Aeos is feasible and safe in microsurgical procedures, and surgical satisfaction was ranked high among most neurosurgeons in our study. The system might offer advanced ergonomic conditions in comparison to conventional ocular-based microscopes.
“…So far, the majority of reports have focused on the VITOM (Karl Storz, Tuttlingen, Germany), the Olympus ORBEYE (Olympus, Tokyo, Japan) and the Zeiss KINEVO (Carl Zeiss AG, Oberkochen, Germany) ( Table 1 ). Only a small number of experimental setups, a cadaver lab study or case reports referred to the utilization of the novel Aesculap Aeos Three-Dimensional Robotic Digital Microscope [ 10 , 12 , 13 ].…”
Objective: Current literature debates the role of newly developed three-dimensional (3D) Exoscopes in the daily routine of neurosurgical practice. So far, only a small number of cadaver lab studies or case reports have examined the novel Aesculap Aeos Three-Dimensional Robotic Digital Microscope. This study aims to evaluate the grade of satisfaction and intraoperative handling of this novel system in neurosurgery. Methods: Nineteen neurosurgical procedures (12 cranial, 6 spinal and 1 peripheral nerve) performed over 9 weeks using the Aeos were analyzed. Ten neurosurgeons of varying levels of training were included after undergoing device instruction and training. Following every surgery, a questionnaire consisting of 43 items concerning intraoperative handling was completed. The questionnaires were analyzed using descriptive statistics. Results: No intraoperative complications occurred. Surgical satisfaction was ranked high (78.95%). In total, 84.21% evaluated surgical ergonomics as satisfactory, while 78.95% of the surgeons would like to use this system frequently. Image quality, independent working zoom function and depth of field were perceived as suboptimal by several neurosurgeons. Conclusion: The use of Aeos is feasible and safe in microsurgical procedures, and surgical satisfaction was ranked high among most neurosurgeons in our study. The system might offer advanced ergonomic conditions in comparison to conventional ocular-based microscopes.
“…Two studies were added to the category “ex vivo: cadavers” [ 13 , 14 ], one study was added to “ex vivo: human placenta” [ 15 ], and three studies were added to “ex vivo: chicken wings” [ 16 - 18 ]. “Virtual reality” contained 11 studies [ 19 - 29 ], “3D static simulators” had six [ 30 - 35 ], and “3D dynamic simulators” had three [ 9 , 36 , 37 ]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…Apart from the aneurysm and the neighboring vessels, some studies also included the skull and/or brain. The studies focused on creating hollow aneurysms [ 31 ] or a total hollow vasculature [ 32 - 34 ] in the model by using elastic 3D-printed material [ 30 , 35 ].…”
Section: Resultsmentioning
confidence: 99%
“…The assessment method for the simulation approach varied across articles. Most articles included a subjective, descriptive questionnaire to assess the face validity, content validity, and/or feasibility [ 9 , 13 - 19 , 21 - 23 , 26 , 30 - 34 , 36 ]. Some articles on VR simulation compared a control group with a VR group; the control group used only conventional presurgical planning tools, while the VR group used a VR simulator to perform presurgical planning [ 19 , 20 , 24 , 28 ].…”
Section: Resultsmentioning
confidence: 99%
“…Some studies included only a limited number of participants [ 23 , 24 , 27 , 31 , 33 , 37 ], leading to bias regarding the level of experience. Other studies simulated only a low number of aneurysms [ 21 , 26 , 28 , 30 , 36 , 37 ], resulting in a bias toward the complexity of the aneurysm case. It is not sure if the studies would have the same outcomes with surgeons of different experience and with other aneurysm complexity cases.…”
Background
With the increasing complexity and decreasing exposure to intracranial aneurysm surgery, training and maintenance of the surgical skills have become challenging. This review elaborated on simulation training for intracranial aneurysm clipping.
Methods
A systematic review was performed according to the PRISMA guidelines to identify studies on aneurysm clipping training using models and simulators. The primary outcome was the identification of the predominant modes of the simulation process, models, and training methods associated with a microsurgical learning curve. The secondary outcomes included assessments of the validation of such simulators and the learning capability from the use of such simulators.
Results
Of the 2068 articles screened, 26 studies met the inclusion criteria. The chosen reports used a wide range of simulation approaches including ex vivo methods (n = 6); virtual reality (VR) platforms (n = 11); and static (n = 6) and dynamic (n = 3) 3D-printed aneurysm models (n = 6). The ex vivo training methods have limited availability, VR simulators lack haptics and tactility, while 3D static models lack important microanatomical components and the simulation of blood flow. 3D dynamic models including pulsatile flow are reusable and cost-effective but miss microanatomical components.
Conclusions
The existing training methods are heterogenous and do not realistically simulate the complete microsurgical workflow. The current simulations lack certain anatomical features and crucial surgical steps. Future research should focus on developing and validating a reusable, cost-effective training platform. No systematic validation method exists for the different training models, so there is a need to build homogenous assessment tools and validate the role of simulation in education and patient safety.
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