Hafez Ahmad, Haeren Roel, Huhtakangas Justiina, Nurminen Ville, Niemelä Mika, Lehecka Martin
Department of Neurosurgery, Helsinki University Hospital, P.O. Box 266, Fin-00029 Helsinki, Finland.
Department of Neurosurgery, Maastricht University Medical Center, Postbus 5800, 6202 AZ Maastricht, The Netherlands.
Life (Basel). 2023 Feb 19;13(2):584. doi: 10.3390/life13020584.
: In recent years, three-dimensional exoscopes have been increasingly applied in neurosurgery. Multiple exoscopic systems are available, all offering specific features. In this study, we assessed practical and visualization performance of four different exoscopic systems in a highly challenging microsurgical procedure, and evaluated whether these affected the quality of work. : We included four different exoscopes: Olympus ORBEYE, Zeiss KINEVO, Storz VITOM, and Aesculap AEOS. With each exoscope, ten experimental bypass procedures were carried out on chicken wing vessels at a depth of 3 cm. We evaluated the quality of the anastomoses, the practical considerations for the setup of the exoscopic systems, and the visualization quality by tracking the number of unnecessary movements. : All included exoscopes enabled us to perform the bypass procedures with mostly adequate or excellent results. Surgically, the most pronounced difference between the exoscopes was the duration of the procedure, which was mainly due to the number of unnecessary movements. Practically, the exoscopes differ highly which is important when considering which exoscope to apply. : This is the first study comparing different exoscope systems while performing the same challenging microsurgical procedure. We found major practical differences between the exoscopes that determine the suitability of an exoscope based on the demands and conditions of the surgical procedure. Therefore, preprocedural practical training with the exoscope is required.
近年来，三维外视镜在神经外科手术中的应用越来越广泛。市面上有多种外视镜系统，各有其独特的特点。在本研究中，我们评估了四种不同外视镜系统在一项极具挑战性的显微外科手术中的实际操作和可视化性能，并评估这些因素是否会影响手术质量。
奥林巴斯ORBEYE、蔡司KINEVO、史托斯VITOM和蛇牌AEOS。使用每种外视镜，在深度为3厘米的鸡翅血管上进行了十次实验性搭桥手术。我们通过追踪不必要动作的数量来评估吻合质量、外视镜系统设置的实际考量以及可视化质量。
所有纳入的外视镜都使我们能够完成搭桥手术，且大多取得了足够或优异的结果。在手术方面，不同外视镜之间最显著的差异在于手术时长，这主要是由于不必要动作的数量不同。在实际应用中，不同外视镜差异很大，这在考虑使用哪种外视镜时很重要。
这是第一项在进行相同具有挑战性的显微外科手术时比较不同外视镜系统的研究。我们发现不同外视镜之间存在重大的实际差异，这些差异根据手术程序的要求和条件决定了外视镜的适用性。因此，术前需要使用外视镜进行实际操作训练。
