Ferlito Salvatore, La Mantia Ignazio, Caruso Sebastiano, Cammaroto Giovanni, Chiesa-Estomba Carlos Miguel, Iannella Giannicola, Nocera Francesco, Ingrassia Angelo, Cocuzza Salvatore, Vicini Claudio, Hans Stephane, Lechien Jerome Rene, Maniaci Antonino
Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia" E.N.T. Section, University of Catania, 95123 Catania, Italy.
Department of Otolaryngology-Head and Neck Surgery, Morgagni Pierantoni Hospital, 47121 Forli, Italy.
J Clin Med. 2022 Jun 23;11(13):3639. doi: 10.3390/jcm11133639.
Over the last decade, technological growth has developed new devices for more precise surgery based on improved maneuverability, minimally invasive approaches, and magnification of the operating field. In this context, the exoscope has opened a new phase for more accurate and safer microsurgery, improving the perception of the volume of objects and the depth of structures for planning, targeting, and controlling fine movements. The exoscope could be used for middle ear, transcanal, transmastoid, and craniotomy procedures that require two-handed dissection, both to perform both totally VITOM-based techniques and coupled to traditional procedures with an operating microscope or endoscope. In addition, the VITOM 3D system allows the surgeon to work with high-definition images, which is essential in facial nerve surgery or submandibular salivary stone or tear surgery approaches, where magnification plays a fundamental role in surgical success and in reducing operating times. The 3D exoscope approach could also be included in traditional transoral procedures for oropharyngeal carcinoma. The exoscope may provide a relevant approach in teaching surgeons and nurses, allowing adequate training in non-oncological surgical procedures such as a tonsillectomy or lateral pharyngoplasty.
在过去十年中，技术的发展催生了基于更高的可操作性、微创方法以及手术视野放大的新型设备，用于更精确的手术。在此背景下，外视镜为更精确、更安全的显微手术开启了新的阶段，提升了对物体体积以及结构深度的感知，有助于手术规划、目标定位以及精细动作控制。外视镜可用于中耳、经耳道、经乳突以及开颅手术等需要双手操作的手术，既可以进行完全基于视频集成手术显微镜（VITOM）的技术，也可以与传统的手术显微镜或内窥镜辅助的手术相结合。此外，VITOM 3D系统使外科医生能够使用高清图像，这在面神经手术、下颌下涎石手术或泪道手术中至关重要，在这些手术中放大倍数对手术成功及缩短手术时间起着关键作用。3D外视镜方法也可纳入传统的口咽癌经口手术中。外视镜在培训外科医生和护士方面可能提供一种有效的途径，便于他们在诸如扁桃体切除术或咽侧成形术等非肿瘤外科手术中进行充分的训练。
