Department of Otorhinolaryngology, Aarhus University Hospital, Skanderborg, Denmark.
Surg Innov. 2024 Oct;31(5):513-519. doi: 10.1177/15533506241273334. Epub 2024 Aug 4.
Operation with a 3D exoscope has recently been introduced in clinical practice. The exoscope consists of two cameras placed in front of the operative field. Images are shown on a large 3D screen with high resolution. The system can be used to enhance precise dissection and provides new possibilities for improved ergonomics, fluorescence, and other optical-guided modalities.
Initial experience with the ultra-high-definition (4K) 3D exoscope in thyroid and parathyroid operations. The exoscope (OrbEye) was mounted on a holding system (Olympus).
We used the exoscope in parathyroidectomy (N = 6) and thyroidectomy (N = 6). Immediate advantages and disadvantages were discussed and recorded. The learning curve for use of the exoscope may be shorter for surgeons with training in endoscopic or robotic procedures. There may be improved ergonomics compared with normal open-neck operations. Further, the optical guided operations can be used with fluorescence and have potential for different on-lay techniques in the future. The 4 K 3D image quality is state-of-art and is highly appreciated during fine surgical dissection and eliminates the need for loupes.
In several ways, using the ORBEYE™ in thyroid and parathyroid surgery provides the surgical team with a new and enhanced experience. This includes improved possibility for teaching, surgical ergonomics, and a 4K 3D camera with a powerful magnification system. However, it is not clear if utilization of these features would improve surgical outcomes. Furthermore, the ORBEYE™ lacks incorporation of parathyroid autofluorescence, and the current costs for the system do not facilitate general access to exoscope assisted operations.
3D 手术外窥镜系统最近已在临床实践中应用。该外窥镜系统由放置在手术视野前方的两个摄像头组成。图像显示在高分辨率的大型 3D 屏幕上。该系统可用于增强精细解剖，并为改善手术的人机工程学、荧光等光学引导方式提供新的可能性。
在甲状腺和甲状旁腺手术中应用超高分辨率（4K）3D 手术外窥镜的初步经验。外窥镜（OrbEye）安装在一个固定系统（Olympus）上。
我们在甲状旁腺切除术（N=6）和甲状腺切除术（N=6）中使用了外窥镜。讨论并记录了直接的优缺点。对于有内镜或机器人手术培训的外科医生，使用外窥镜的学习曲线可能更短。与常规的开放式颈部手术相比，手术的人机工程学可能得到改善。此外，光学引导操作可以与荧光结合使用，并且在未来可能具有不同的覆盖技术的潜力。4K 3D 图像质量是目前的最新技术，在精细的手术解剖中非常有用，并且消除了对放大镜的需求。
在甲状腺和甲状旁腺手术中使用 ORBEYE™，从多个方面为手术团队提供了全新且增强的体验。这包括改进的教学、手术人机工程学以及具有强大放大系统的 4K 3D 摄像头的可能性。然而，尚不清楚这些功能的使用是否会改善手术结果。此外，ORBEYE™ 缺乏甲状旁腺自发荧光的功能，并且目前该系统的成本无法使外窥镜辅助手术普遍普及。
