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使用4K-3D电子内窥镜进行神经外科手术的三医生六手操作:病例报告

A Three-Surgeon-Six-Hand Operation Using a 4K-3D Exoscope for Neurological Surgery: A Case Report.

作者信息

Tamura Ryota, Kuranari Yuki, Katayama Makoto

机构信息

Department of Neurosurgery, Keio University School of Medicine, Shinjuku, Japan.

Department of Neurosurgery, Kawasaki Municipal Hospital, Kawasaki, Japan.

出版信息

Front Surg. 2022 Mar 11;9:866476. doi: 10.3389/fsurg.2022.866476. eCollection 2022.

Abstract

BACKGROUND

Advances in digital imaging including evolving of 3-dimensional (3D) exoscope has allowed its use as an alternative to microscopes in neurosurgery. The exoscope can concede wide space around the operating table and patient. Here, we show a three-surgeon-six-hand operative approach using a 4K-3D exoscope. Practical advantages and disadvantages of this approach are discussed.

CLINICAL PRESENTATION

A 58-year-old male was refered with a 60 mm diameter meningioma in the right frontal convexity. The tumor removal was done by an operator and two assistants with a scrub nurse while viewing images displayed on a 55-inch monitor with integrated 4K and 3D visualization technology retrieved by KINEVO®. Meaningful communication between the operator and two assistants allowed for simultaneous, and precise surgical procedures. Gross total removal was achieved without damaging the brain.

CONCLUSION

The ocular-free, openness of 4K-3D exoscope allows for a three-surgeon-six-handed operation, which leads to simultaneous surgical maneuvers by multiple hands, shorter operative time, flexible/intermittent brain retraction made by two assistants, and educational benefits owing to the surgical procedure being visually shared.

摘要

背景

包括三维(3D)外视镜技术发展在内的数字成像技术进步,使其在神经外科手术中可替代显微镜使用。外视镜可为手术台和患者周围留出宽敞空间。在此,我们展示一种使用4K-3D外视镜的三医生六手手术方法。并讨论了该方法的实际优缺点。

临床表现

一名58岁男性因右侧额部凸面直径60毫米的脑膜瘤前来就诊。肿瘤切除由一名术者、两名助手以及一名刷手护士进行,同时通过KINEVO®获取的集成4K和3D可视化技术在55英寸显示器上查看图像。术者与两名助手之间有意义的沟通使得手术能够同时且精确地进行。实现了肿瘤全切且未损伤脑组织。

结论

4K-3D外视镜无需眼部操作且具有开放性,可实现三医生六手手术,这使得多手能同时进行手术操作、缩短手术时间、两名助手可灵活/间歇性地进行脑牵拉,并且由于手术过程可视觉共享而具有教学优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94fe/8961730/0bc7911e05ea/fsurg-09-866476-g0001.jpg

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