Neurosurgery Clinic, Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi University Hospital and University of Florence, Florence, Italy.
J Neurol Surg A Cent Eur Neurosurg. 2021 Sep;82(5):484-489. doi: 10.1055/s-0040-1719106. Epub 2021 Mar 9.
The introduction of exoscopes in neurosurgery has been welcomed due to their maneuverability, ergonomics, and low-profile frame. 3D devices have further enabled a better stereoscopic visualization. Reports on their application, albeit more and more frequent, are still at their beginning stages. We present our experience with the Olympus ORBEYE 4K-3D exoscope for major cranial procedures. The strengths and weaknesses of the exoscope are presented, and the nuances associated with the learning curve are illustrated.
Over 2 weeks, patients undergoing surgery for major cranial pathologies were offered to participate in this evaluation of the Olympus ORBEYE 4K-3D exoscope. Information on the use of the exoscope was collected to assess the features and struggles in the learning curve. A comparison with the operating microscope was made.
Fourteen patients with different intracranial pathologies were operated on with the exoscope. No surgery-related complications occurred. The microsurgical part was performed with the exoscope in six cases. The exoscope was used for 72.9% (±37.5%) of the whole microsurgical time vs. 27.1% (±37.5%) microscope time ( = 0.02).
The Olympus ORBEYE 4K-3D exoscope represents a useful evolution of the operating microscope. It requires time to overcome potential difficulties, mostly related to previous motor schemes acquired with operating microscopes. Its features could represent the basis for a paradigm shift in microsurgery.
神经外科引入内窥镜以来，由于其可操作性、人体工程学和低轮廓框架而受到欢迎。3D 设备进一步实现了更好的立体可视化。尽管越来越频繁地报告了它们的应用，但仍处于起步阶段。我们介绍了我们在大型颅脑手术中使用奥林巴斯 ORBEYE 4K-3D 内窥镜的经验。介绍了内窥镜的优缺点，并说明了与学习曲线相关的细微差别。
在两周的时间内，为接受主要颅底病变手术的患者提供了参与这项奥林巴斯 ORBEYE 4K-3D 内窥镜评估的机会。收集了有关内窥镜使用情况的信息，以评估学习曲线的特点和困难。并与手术显微镜进行了比较。
14 例不同颅内病变患者接受了内窥镜手术。无手术相关并发症。6 例患者采用内窥镜进行显微外科手术。内窥镜的使用时间占整个显微镜时间的 72.9%（±37.5%），而显微镜时间占 27.1%（±37.5%）（ = 0.02）。
奥林巴斯 ORBEYE 4K-3D 内窥镜是手术显微镜的有益发展。它需要时间来克服潜在的困难，这些困难主要与之前使用手术显微镜获得的运动方案有关。其特点可能为显微外科手术带来范式转变。
