Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
Division of Colon and Rectal Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
Int J Colorectal Dis. 2024 Oct 15;39(1):163. doi: 10.1007/s00384-024-04739-z.
Recently, exoscope was introduced as a more ergonomic alternative to microscope, mainly in nerve and spinal surgery. Exoscope use in general surgery is still experimental and just few reports are present in literature. Here, we describe for the first time its application in transanal surgery, specifically during the transanal transection and single-stapled anastomosis in ileal-pouch anal anastomosis.
After completing the proctectomy and pouch formation laparoscopically, two surgeons performed the transanal transection and single-stapled anastomosis using the vision provided by the ORBEYE™ exoscope system with a 3D 4K orbital camera and a 55-inches 3D screen. The transanal procedure was carried out with the surgeons looking at the 3D screen rather than at the operating field.
The system subjectively provided excellent operative view thanks to the magnification capacity and the high resolution. The ergonomics was improved compared to classical transanal surgery, allowing the operators and observers to have the same view in a comfortable position. In particular, the exoscope magnified vision allowed for clearer demonstration of techniques to trainees.
This is the first report on the intraoperative application of the ORBEYE™ surgical exoscope in transanal surgery. The magnified vision allowed precise movements and the system appeared potentially a ground-breaking tool for surgical training. The ability to project high-quality images to observers make it ideal for teaching complex transanal procedures. Further studies are encouraged to validate this approach into standard colorectal practice.
最近，内窥镜作为显微镜的一种更符合人体工程学的替代方法，主要应用于神经和脊柱外科。内窥镜在普通外科中的应用仍处于实验阶段，文献中仅有少数报道。在这里，我们首次描述了其在经肛门手术中的应用，特别是在经肛门直肠切除术和单吻合器吻合术在回肠袋肛门吻合术中的应用。
在腹腔镜下完成直肠切除术和袋形成后，两名外科医生使用 ORBEYE™内窥镜系统的视野进行经肛门直肠切除术和单吻合器吻合术，该系统配备了 3D 4K 轨道摄像头和 55 英寸 3D 屏幕。经肛门手术是通过外科医生观看 3D 屏幕而不是手术区域来进行的。
该系统主观上提供了出色的手术视野，得益于其放大能力和高分辨率。与传统的经肛门手术相比，其符合人体工程学的设计提高了手术的舒适性，允许手术者和观察者以舒适的姿势观看相同的视野。特别是，内窥镜的放大视觉使受训者能够更清晰地展示技术。
这是关于 ORBEYE™手术内窥镜在经肛门手术中术中应用的首次报道。放大的视野允许进行精确的手术操作，该系统似乎是手术培训的一项突破性工具。该系统能够向观察者投射高质量的图像，使其成为教授复杂经肛门手术的理想选择。鼓励进一步的研究来验证这种方法在标准结直肠实践中的应用。
