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脊柱外科新时代:探索使用手术显微镜的可行替代方案——外视镜:系统评价和荟萃分析。

The New Era of Spinal Surgery: Exploring the Use of Exoscopes as a Viable Alternative to Operative Microscopes-A Systematic Review and Meta-Analysis.

机构信息

Department of General Medicine, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina.

Department of General Medicine, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina; Department of Anatomy, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina.

出版信息

World Neurosurg. 2024 Feb;182:144-158.e1. doi: 10.1016/j.wneu.2023.11.026. Epub 2023 Nov 10.

Abstract

BACKGROUND

The growing interest in exoscopic (EX) technology has prompted a comprehensive evaluation of its clinical, functional, and financial outcomes in neurosurgery. This systematic review and meta-analysis aimed to explore the utilization of EX in spine surgery and assess their safety, efficacy, and impact on surgical outcomes.

METHODS

A thorough literature review was conducted using PubMed, Scopus, and Embase databases in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The study focused on articles concerning the application of EXs in spinal surgical procedures. The inclusion criteria encompassed various study designs presenting clinical data and intraoperative experiences related to EX utilization in spine surgery.

RESULTS

The meta-analysis included studies examining various aspects of EX utilization, such as intraoperative complications, video/image quality, surgical field visualization, ease of manipulation, ergonomic characteristics, educational utility, surgical duration, and team involvement. Findings indicated that EXs offered superior video quality and favorable ergonomic features. Comparable outcomes were observed in surgical duration, intraoperative blood loss, time to discharge, and postoperative pain levels between EX and conventional microscope approaches.

CONCLUSIONS

This study provides valuable insights into the utilization of EXs in spine surgery, demonstrating their potential advantages and comparable outcomes with conventional microscopes.

摘要

背景

对外显(EX)技术的兴趣日益浓厚,促使人们全面评估其在神经外科的临床、功能和财务结果。本系统评价和荟萃分析旨在探讨 EX 在脊柱手术中的应用,并评估其安全性、疗效以及对手术结果的影响。

方法

根据系统评价和荟萃分析的首选报告项目指南,使用 PubMed、Scopus 和 Embase 数据库进行了全面的文献回顾。本研究关注的是关于 EX 在脊柱手术程序中的应用的文章。纳入标准包括各种研究设计,提出了与 EX 在脊柱外科应用相关的临床数据和术中经验。

结果

荟萃分析包括研究 EX 利用的各个方面,如术中并发症、视频/图像质量、手术视野可视化、操作便利性、人体工程学特征、教育实用性、手术时间和团队参与。结果表明,EX 提供了卓越的视频质量和良好的人体工程学特征。EX 和传统显微镜方法在手术时间、术中失血量、出院时间和术后疼痛水平方面的结果相当。

结论

本研究深入探讨了 EX 在脊柱手术中的应用,展示了其与传统显微镜相比的潜在优势和相当的结果。

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