Tamura Ryota, Kuranari Yuki, Katayama Makoto
Department of Neurosurgery, Keio University School of Medicine, Shinjuku, Japan.
Department of Neurosurgery, Kawasaki Municipal Hospital, Kawasaki, Japan.
Front Surg. 2022 Mar 11;9:866476. doi: 10.3389/fsurg.2022.866476. eCollection 2022.
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.
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.
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.
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。
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。
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。