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Yasuo Murai, Shun Sato, Kanako Yui, Daijiro Morimoto, Tomohiro Ozeki, Masahiro Yamaguchi, Kojiro Tateyama, Toshiki Nozaki, Shigeyuki Tahara, Fumio Yamaguchi, Akio Morita
BACKGROUND: The exoscope has been reported as a novel neurosurgical instrumentation in clinical practice. OBJECTIVE: To investigate the possibility that ORBEYE (OE), a novel instrument that excludes eyepiece lenses and allows for microsurgery by observation of the 4K3D monitor, could replace microscopes. METHODS: We report 22 clinical cases by 5 experienced neurosurgeons and the comparative results of training 10 residents. An observation study with questionnaire survey was conducted on usability...
December 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
Erez Nossek, Julia R Schneider, Kevin Kwan, Kay O Kulason, Victor Du, Shamik Chakraborty, Ralph Rahme, Lukas Faltings, Jason Ellis, Rafael Ortiz, John A Boockvar, David J Langer
BACKGROUND: Cerebral bypass operation is a technically challenging operation that requires excellent surgical visibility and efficient ergonomics to minimize complications and maximize successful revascularization. Despite the operative microscope's utilization for the past two generations, there remains a need for continued improvement in operative visualization and surgical ergonomics. OBJECTIVE: To report the positives and negatives of our initial experience using a novel 4 K high-definition (4K-HD) 3-dimensional (3D) exoscope (EX) for cranial bypass surgery...
December 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
Troy Dawley, Michael Schulder
No abstract text is available yet for this article.
November 28, 2018: Operative Neurosurgery (Hagerstown, Md.)
Alexander A Khalessi, Ralph Rahme, Robert C Rennert, Pia Borgas, Jeffrey A Steinberg, Timothy G White, David R Santiago-Dieppa, John A Boockvar, Dustin Hatefi, J Scott Pannell, Michael Levy, David J Langer
BACKGROUND: During its development and preclinical assessment, a novel, 3-dimensional (3D), high-definition (4K-HD) exoscope system was formerly shown to provide an immersive surgical experience, while maintaining a portable, low-profile design. OBJECTIVE: To assess the clinical applicability of this 3D 4K-HD exoscope via first-in-man surgical use. METHODS: The operative workflow, functionality, and visual haptics of the 3D 4K-HD exoscope were assessed in a variety of microneurosurgical cases at 2 US centers...
November 26, 2018: Operative Neurosurgery (Hagerstown, Md.)
Evgenii G Belykh, Xiaochun Zhao, Claudio Cavallo, Michael A Bohl, Kaan Yagmurlu, Joseph L Aklinski, Vadim A Byvaltsev, Nader Sanai, Robert F Spetzler, Michael T Lawton, Peter Nakaji, Mark C Preul
Background We assessed a new robotic visualization platform with novel user-control features and compared its performance to the previous model of operative microscope. Methods In a neurosurgery research laboratory, we performed anatomical dissections and assessed robotic, exoscopic, endoscopic, fluorescence functionality. Usability and functionality were tested in the operating room over 1 year. Results The robotic microscope showed higher sensitivity for fluorescein sodium, higher detail in non-fluorescent background, and recorded/presented pictures with color quality similar to observation through the oculars...
July 30, 2018: Curēus
Brain D Sindelar, Vimal Patel, Shakeel Chowdhry, Julian E Bailes
Intracerebral hemorrhage (ICH) with or without intraventricular hemorrhage (IVH) is a highly morbid disease process due to the mass effect and secondary injury that occurs upon the surrounding brain. Historically, surgical evacuation has failed to demonstrate improved outcomes in comparison to standard medical therapy likely due to the significant brain trauma when accessing the clot. Recent minimally invasive techniques have proposed a way to improve outcomes by reducing this injury. We report here a 62-year-old male with ICH and IVH with acute neurological deterioration due to hydrocephalus was found to have no improvement following external ventricular drainage...
July 13, 2018: Curēus
David Mampre, Alexandra Bechtle, Kaisorn L Chaichana
OBJECTIVE: Posterior fossa tumor surgery is associated with a significant risk of complications, and the complications are typically more frequent compared with similar supratentorial surgeries. This study aimed to evaluate 1) the extent of resection and neurologic outcomes and 2) perioperative complications with use of minimally invasive approaches for intra-axial posterior fossa tumors from our case series. METHODS: All consecutive patients who underwent nonbiopsy surgery of a posterior fossa tumor using tubular retractors and exoscopic visualization from January 2016 to May 2018 were prospectively identified and included...
November 2018: World Neurosurgery
Kevin Kwan, Julia R Schneider, Victor Du, Lukas Falting, John A Boockvar, Jonathan Oren, Mitchell Levine, David J Langer
BACKGROUND: The operative microscope has significantly advanced modern neurosurgical spine surgery but continues to be limited by high costs, suboptimal optics, poor ergonomics, and difficulties with maneuverability. We believe the novel 4K high-definition (4K-HD) 3-dimensional (3D) exoscope (EX), may improve the surgical corridor through advancements in illumination, ergonomics, magnification, and depth of field and has the potential to be utilized in neurosurgical education and training...
August 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Evgenii Belykh, Laeth George, Xiaochun Zhao, Alessandro Carotenuto, Leandro Borba Moreira, Kaan Yağmurlu, Baran Bozkurt, Vadim A Byvaltsev, Peter Nakaji, Mark C Preul
Background: Extracranial-intracranial bypass is a challenging procedure that requires special microsurgical skills and an operative microscope. The exoscope is a tool for neurosurgical visualization that provides view on a heads-up display similar to an endoscope, but positioned external to the operating field, like a microscope. The authors carried out a proof-of-concept study evaluating the feasibility and effectiveness of performing microvascular bypass using various new exoscopic tools...
2018: Surgical Neurology International
Joshua Bakhsheshian, Ben A Strickland, Christina Jackson, Kaisorn L Chaichana, Ronald Young, Gustavo Pradilla, Jefferson W Chen, Julian Bailes, Gabriel Zada
BACKGROUND: Recent advancements have aimed to optimize visualization and minimize insult to healthy cortical and subcortical tissue through the use of tubular-based retractors. OBJECTIVE: To investigate outcomes following resection of cerebral metastases using an integrated tubular retraction system with an exoscope and neuronavigation. METHODS: A multicenter retrospective analysis of surgical outcomes in consecutive patients who underwent resection of a brain metastasis using a tubular retraction system and exoscope was performed...
April 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
Rajiv Iyer, Kaisorn L Chaichana
BACKGROUND AND STUDY AIMS/OBJECTIVE:  Deep-seated high-grade gliomas (HGGs) represent a unique surgical challenge because they reside deep to critical cortical and subcortical structures and infiltrate functional areas of the brain. Therefore, accessing and resecting these tumors can often be challenging and associated with significant morbidity. We describe the use of minimally invasive approaches to access deep-seated HGGs to achieve extensive resections while minimizing surgical morbidity...
July 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Kelly Gassie, Olindi Wijesekera, Kaisorn L Chaichana
Deep-seated, subcortical tumors represent a surgical challenge. The traditional approach to these lesions involve large craniotomies, fixed retractor systems, and extensive white matter dissection, each with their own associated morbidity. We describe our experience with the use of tubular retractors for accessing these deep-seated lesions. Fifty consecutive patients operated on for an intra-axial brain tumor (both biopsies and resection) from January 2016 to December 2017 by a single surgeon using tubular retractors with exoscopic visualization were prospectively identified and included in this consecutive case series...
April 18, 2018: Journal of Neurosurgical Sciences
Thomas Beez, Christopher Munoz-Bendix, Kerim Beseoglu, Hans-Jakob Steiger, Sebastian A Ahmadi
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)...
January 24, 2018: Curēus
Joham Choque-Velasquez, Roberto Colasanti, Juhani Collan, Riina Kinnunen, Behnam Rezai Jahromi, Juha Hernesniemi
OBJECTIVE: Microsurgical skills and eye-hand coordination need continuous training to be developed and refined. However, well-equipped microsurgical laboratories are not so widespread as their setup is expensive. Herein, we present a novel microsurgical training system that requires a high-resolution personal computer screen, smartphones, and virtual reality glasses. METHODS: A smartphone placed on a holder at a height of about 15-20 cm from the surgical target field is used as the webcam of the computer...
April 2018: World Neurosurgery
Howard L Weiner, Dimitris G Placantonakis
The resection of deep-seated brain tumors has been associated with morbidity due to injury to critical neural structures during the approach. Recent technological advancements in navigation and stereotaxy, surgical planning, brain tractography and minimal-access brain ports present the opportunity to overcome such limitations. Here, we present the case of a pediatric patient with a left thalamic/midbrain juvenile pilocytic astrocytoma (JPA). The tumor displaced the corticospinal fibers posteriorly and resulted in hemiparesis...
October 11, 2017: Curēus
Jayson Sack, Jeffrey A Steinberg, Robert C Rennert, Dustin Hatefi, Jeffrey S Pannell, Michael Levy, Alexander A Khalessi
BACKGROUND: The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal optics, ergonomics, and maneuverability. A recently developed extracorporeal telescope ("exoscope") operative system combines characteristics from both the operative microscope and endoscope and provides an affordable, portable, high-definition operative experience. Widespread use of exoscopes in neurosurgery has previously been limited by a lack of stereopsis with 2-dimensional(2-D) monitors...
April 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Zefferino Rossini, Andrea Cardia, Davide Milani, Giovanni Battista Lasio, Maurizio Fornari, Vincenzo D'Angelo
BACKGROUND: Optimal vision and ergonomics are important factors contributing to achievement of good results during neurosurgical interventions. The operating microscope and the endoscope have partially filled the gap between the need for good surgical vision and maintenance of a comfortable posture during surgery. Recently, a new technology called video-assisted telescope operating monitor or exoscope has been used in cranial surgery. The main drawback with previous prototypes was lack of stereopsis...
November 2017: World Neurosurgery
Joachim M Oertel, Benedikt W Burkhardt
BACKGROUND: The authors describe the application of a new exoscope that offers 3-dimensional (3D) visualization in cranial and spinal neurosurgery in detail. METHODS: Five cranial and 11 spinal procedures were performed with a 3D exoscope. Instrument handling, repositioning of the exoscope, handling of the image control unit, the adjustment of magnification and focal length, the depth perception, the image quality, the illumination, and the comfort level of the posture during the procedure were assessed via a questionnaire...
September 2017: World Neurosurgery
Kenichi Nishiyama
An exoscope, high-definition video telescope operating monitor system to perform microsurgery has recently been proposed an alternative to the operating microscope. It enables surgeons to complete the operation assistance by visualizing magnified images on a display. The strong points of exoscope are the wide field of view and deep focus. It minimized the need for repositioning and refocusing during the procedure. On the other hand, limitation of magnifying object was an emphasizing weak point. The procedures are performed under 2D motion images with a visual perception through dynamic cue and stereoscopically viewing corresponding to the motion parallax...
May 2017: Journal of Korean Neurosurgical Society
Christina Jackson, Gary L Gallia, Kaisorn L Chaichana
No abstract text is available yet for this article.
November 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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