Hofmann Elena, Doll Christian, Koerdt Steffen, Kurth Cynthia, Heiland Max, Kreutzer Kilian
Department of Oral and Maxillofacial Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
BIH Biomedical Innovation Academy, BIH Charité Junior Clinician Scientist Program, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Oral Maxillofac Surg. 2025 Feb 3;29(1):50. doi: 10.1007/s10006-025-01342-6.
To assess the clinical utility of the 3D 4K exoscope for reconstructive head and neck surgery.
This retrospective study analyzed surgical details and complications with the use of the 3D 4K exoscope for microvascular reconstruction at a high-volume Department of Oral and Maxillofacial Surgery, compared to the use of a 2D microscope. Patients with oral cancer undergoing microvascular reconstruction were categorized into two cohorts based on the intraoperative use of the 3D 4K exoscope (Orbeye™, Olympus, Tokyo, Japan) or a conventional microscope (ZEISS S8 - OPMI Vario, Carl Zeiss AG, Oberkochen, Germany; Leica M680, Leica Mikrosysteme Vertrieb GmbH, Wetzlar, Germany) during a six-month study period, respectively. Outcomes were also compared between two time periods of the exoscope use to assess the learning curve over time.
The exoscope was applied for microvascular anastomosis in 55 surgical cases (cohort 1), and the conventional microscope was employed in 56 cases (cohort 2). The rates of postoperative complications within 14 days following the use of the exoscope were 14.5% (N = 8), compared to 16.1% (N = 9) in cohort 2. Analysis over time demonstrated a learning curve with the exoscope, reflected in a decrease in postoperative complications within 14 days from 22.7 to 9.1%.
The three-dimensional camera system provides excellent and reliable intraoperative visualization in reconstructive head and neck surgery. Transitioning to this new technology did not lead to an increase in intra- or postoperative complications, but the successful implementation requires some experience with the device.
评估3D 4K电子内窥镜在头颈部重建手术中的临床实用性。
这项回顾性研究分析了在一家大型口腔颌面外科使用3D 4K电子内窥镜进行微血管重建的手术细节和并发症，并与使用2D显微镜进行了比较。在为期六个月的研究期间，根据术中使用3D 4K电子内窥镜（日本东京奥林巴斯公司的Orbeye™）或传统显微镜（德国奥伯科亨卡尔蔡司公司的ZEISS S8 - OPMI Vario；德国韦茨拉尔徕卡微系统销售有限公司的Leica M680），将接受微血管重建的口腔癌患者分为两个队列。还比较了电子内窥镜使用的两个时间段的结果，以评估随时间的学习曲线。
电子内窥镜应用于55例手术病例的微血管吻合（队列1），传统显微镜应用于56例病例（队列2）。使用电子内窥镜后14天内的术后并发症发生率为14.5%（N = 8），而队列2为16.1%（N = 9）。随时间分析显示电子内窥镜存在学习曲线，表现为术后14天内并发症从22.7%降至9.1%。
三维摄像系统在头颈部重建手术中提供了出色且可靠的术中可视化。向这项新技术的过渡并未导致术中或术后并发症增加，但成功实施需要对该设备有一定经验。
