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3D 外视镜辅助手术能否取代传统鼻成形术中的内窥镜?基于我们两年经验的分析。

Can 3D Exoscopy-Assisted Surgery Replace the Traditional Endoscopy in Septoplasty? Analysis of Our Two-Year Experience.

作者信息

Catalfamo Luciano, Calvo Alessandro, Cicchiello Samuele, La Fauci Antonino, De Ponte Francesco Saverio, Scozzaro Calogero, De Rinaldis Danilo

机构信息

Department of Biomedical, Dental and Morphological and Functional Imaging (BIOMORF), University of Messina, Via Consolare Valeria n. 1, 98122 Messina, Italy.

出版信息

J Clin Med. 2025 Jul 25;14(15):5279. doi: 10.3390/jcm14155279.


DOI:10.3390/jcm14155279
PMID:40806901
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12347903/
Abstract

: Septoplasty is a commonly performed surgical procedure aimed at correcting nasal septal deviations, to improve nasal airflow and respiratory function. Traditional approaches to septal correction rely on either direct visualization or endoscopic guidance. Recently, a novel technology known as exoscopy has been introduced into surgical practice. Exoscopy is an "advanced magnification system" that provides an enlarged, three-dimensional view of the operating field. In this article, we present our experience with exoscope-assisted septoplasty, developed over the last two years, and compare it with our extensive experience using the endoscopic approach. : Our case series includes 26 patients, predominantly males and young adults, who underwent exoscope-assisted septoplasty. We discuss the primary advantages of this technique and, most importantly, provide an analysis of its learning curve. The cohort of patients treated using the exoscopic approach was compared with a control group of 26 patients who underwent endoscope-guided septoplasty, randomly selected from our broader clinical database. Finally, we present a representative surgical case that details all phases of the exoscope-assisted procedure. : Our surgical experience has demonstrated that exoscopy is a safe and effective tool for performing septoplasty. Moreover, the learning curve associated with this technique exhibits a rapid and progressive improvement. Notably, exoscopy provides a substantial educational benefit for trainees and medical students, as it enables them to share the same visual perspective as the lead surgeon. : Although further studies are required to validate this approach, we believe that exoscopy represents a promising advancement for a wide range of head and neck procedures, and certainly for septoplasty.

摘要

鼻中隔成形术是一种常见的外科手术,旨在矫正鼻中隔偏曲,改善鼻腔气流和呼吸功能。传统的鼻中隔矫正方法依赖于直接可视化或内镜引导。最近,一种名为外视镜检查的新技术已被引入外科手术实践。外视镜检查是一种“先进的放大系统”,可提供手术视野的放大三维视图。在本文中,我们介绍了过去两年中开展的外视镜辅助鼻中隔成形术的经验,并将其与我们使用内镜方法的丰富经验进行了比较。

我们的病例系列包括26例患者,主要为男性和年轻人,他们接受了外视镜辅助鼻中隔成形术。我们讨论了该技术的主要优点,最重要的是,对其学习曲线进行了分析。将使用外视镜方法治疗的患者队列与从我们更广泛的临床数据库中随机选择的26例接受内镜引导鼻中隔成形术的对照组患者进行了比较。最后,我们展示了一个具有代表性的手术病例,详细介绍了外视镜辅助手术的各个阶段。

我们的手术经验表明,外视镜检查是进行鼻中隔成形术的一种安全有效的工具。此外,与该技术相关的学习曲线显示出快速且逐步的改善。值得注意的是,外视镜检查为实习生和医学生提供了巨大的教育益处,因为它使他们能够与主刀医生共享相同的视觉视角。

尽管需要进一步的研究来验证这种方法,但我们相信外视镜检查对于广泛的头颈手术,当然对于鼻中隔成形术来说,是一个有前途的进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/ec4dd574a2cc/jcm-14-05279-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/a3d6d60956b0/jcm-14-05279-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/f20f8fb69b3c/jcm-14-05279-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/4588e8dccc74/jcm-14-05279-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/f67de8182941/jcm-14-05279-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/310c8d1e880a/jcm-14-05279-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/ec4dd574a2cc/jcm-14-05279-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/a3d6d60956b0/jcm-14-05279-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/f20f8fb69b3c/jcm-14-05279-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/4588e8dccc74/jcm-14-05279-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/f67de8182941/jcm-14-05279-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/310c8d1e880a/jcm-14-05279-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98da/12347903/ec4dd574a2cc/jcm-14-05279-g006.jpg

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本文引用的文献

[1]
Exoscopic Clipping of an Unruptured Anterior Inferior Cerebellar Artery Origin Aneurysm Through a Retrosigmoid Approach: 2-Dimensional Operative Video.

Oper Neurosurg. 2025-4-18

[2]
Does the visual system affect the learning curve of the Otosurgeon? A cadaveric study comparing microscopy vs exoscopy.

Eur Arch Otorhinolaryngol. 2025-3-26

[3]
First experience with VITOM eagle in micro-laryngeal surgery on 3D-printed laryngeal models: important improvements in exoscopic technology.

Eur Arch Otorhinolaryngol. 2025-3-14

[4]
Carotid Artery Stenting by Direct Punctures of Cervical Carotid Artery Stenoses Using an Exoscope in a Hybrid Operating Room: A Technical Report.

Cureus. 2024-9-28

[5]
New 3-D Technologies in Salivary Gland Surgery: The Exoscope-Assisted Surgery for Treatment of Benign Tumors of Parotid Gland.

Indian J Otolaryngol Head Neck Surg. 2024-10

[6]
Endoscopic and exoscopic surgery for brain tumors.

Int J Clin Oncol. 2024-10

[7]
Septoplasty During Primary Cleft Lip Reconstruction: A Historical Perspective and Scoping Review.

J Craniofac Surg. 2024-10-1

[8]
A commentary on 'Neurosurgical application of pineal region tumor resection with 3D 4K exoscopy via infratentorial approach: a retrospective cohort study'.

Int J Surg. 2024-3-1

[9]
Introducing next-generation transcranial surgery with the head-mounted 3D View Vision display in extracorporeal microsurgery: illustrative cases.

J Neurosurg Case Lessons. 2023-12-4

[10]
VITOM 3D exoscopic system compared to microsurgical technique in spinal surgery.

Zh Vopr Neirokhir Im N N Burdenko. 2023

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