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Filippo Flavio Angileri, Felice Esposito, Antonino Scibilia, Stefano Maria Priola, Giovanni Raffa, Antonino Germanò
This video shows an exoscope-guided single-stage resection with 3-dimensional technology of a supratentorial cavernoma and a supratentorial hemangioblastoma during the same surgical procedure. The patient is a 42-yr-old man with a history of generalized tonico-clonic seizures. Contrast-enhanced magnetic resonance (MR) revealed the presence of a left frontal cavernoma and a left T1 non-enhancing hypointese temporal lesion (hemangioblastoma). The operation was carried out in the lateral position with the sole use of a 3D-exoscope (VITOM-3D, Karl Storz GmbH&Co, Tuttlingen, Germany)...
March 8, 2019: Operative Neurosurgery (Hagerstown, Md.)
Nikolay Lasunin, Denis A Golbin
Background The aim of the project was to show the peculiarities of manipulations in two-dimensional (2D) visualization and to enlighten young neurosurgical residents for further independent training of their manual skills in the anatomic lab. The course followed a step-by-step training program starting with artificial models in a static 2D exoscopic view field with subsequent transition to cadaveric animal models and the use of dynamic four-hand techniques and endoscopy. Materials and methods Since 2015, two 2-day workshops and four 1-day workshops have been organized...
November 30, 2018: Curēus
Luca Ricciardi, Kaisorn L Chaichana, Andrea Cardia, Vito Stifano, Zefferino Rossini, Alessandro Olivi, Carmelo Lucio Sturiale
No abstract text is available yet for this article.
January 17, 2019: World Neurosurgery
Cristoph Griessenauer, Caroline Medin, Oded Goren, Clemens M Schirmer
Introduction Novel image-guided, minimally invasive techniques to evacuate intracerebral hematomas represent a promising new avenue in the management of this disease entity. To our knowledge, a direct comparison of the Penumbra Apollo (Penumbra Inc, Alameda, California, US) and Nico BrainPath (Indianapolis, Indiana, US) system has not yet been performed. Methods A retrospective review of image-guided, minimally invasive evacuation of intracerebral hematomas performed at one academic institution in the United States between July 2015 and July 2017 was performed...
November 10, 2018: Curēus
Jonathan C Garneau, Benjamin M Laitman, Maura K Cosetti, Constantinos Hadjipanayis, George Wanna
OBJECTIVE: We describe our experience using the extracorporeal video microscope, the "exoscope" for various applications within the field of lateral skull base surgery. STUDY DESIGN: A retrospective case series was performed investigating patient demographics, indications for surgery, procedure type, operative time, approach to the skull base, complications, adequacy of visualization, and surgeon comfortability. PATIENTS: Six cases were performed with a three dimensional surgical exoscope, obviating the use of a traditional binocular microscope...
February 2019: Otology & Neurotology
Sullivan Smith, Elliott D Kozin, Vivek V Kanumuri, Samuel R Barber, Douglas Backous, João Flávio Nogueira, Daniel J Lee
Extracorporeal video microscopes, or "exoscopes," provide high-definition views of the operative field and are alternatives to the operating microscope or loupes for large-corridor surgical approaches. In this proof-of-concept study, we aim to determine the feasibility of 3-dimensional exoscopes as alternatives to operating microscopes in otology and neurotology, espeically in conjunction with endoscopes. Eleven consecutive cases were performed using 3-dimensional exoscopes in place of, or as adjuncts to, the operating microscope...
January 1, 2019: Otolaryngology—Head and Neck Surgery
Yasuo Murai, Shun Sato, Kanako Yui, Daijiro Morimoto, Tomohiro Ozeki, Masahiro Yamaguchi, Kojiro Tateyama, Toshiki Nozaki, Shigeyuki Tahara, Fumio Yamaguchi, Akio Morita
BACKGROUND: The exoscope has been reported as a novel neurosurgical instrumentation in clinical practice. OBJECTIVE: To investigate the possibility that ORBEYE (OE), a novel instrument that excludes eyepiece lenses and allows for microsurgery by observation of the 4K3D monitor, could replace microscopes. METHODS: We report 22 clinical cases by 5 experienced neurosurgeons and the comparative results of training 10 residents. An observation study with questionnaire survey was conducted on usability...
December 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
Erez Nossek, Julia R Schneider, Kevin Kwan, Kay O Kulason, Victor Du, Shamik Chakraborty, Ralph Rahme, Lukas Faltings, Jason Ellis, Rafael Ortiz, John A Boockvar, David J Langer
BACKGROUND: Cerebral bypass operation is a technically challenging operation that requires excellent surgical visibility and efficient ergonomics to minimize complications and maximize successful revascularization. Despite the operative microscope's utilization for the past two generations, there remains a need for continued improvement in operative visualization and surgical ergonomics. OBJECTIVE: To report the positives and negatives of our initial experience using a novel 4 K high-definition (4K-HD) 3-dimensional (3D) exoscope (EX) for cranial bypass surgery...
December 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
Troy Dawley, Michael Schulder
No abstract text is available yet for this article.
November 28, 2018: Operative Neurosurgery (Hagerstown, Md.)
Alexander A Khalessi, Ralph Rahme, Robert C Rennert, Pia Borgas, Jeffrey A Steinberg, Timothy G White, David R Santiago-Dieppa, John A Boockvar, Dustin Hatefi, J Scott Pannell, Michael Levy, David J Langer
BACKGROUND: During its development and preclinical assessment, a novel, 3-dimensional (3D), high-definition (4K-HD) exoscope system was formerly shown to provide an immersive surgical experience, while maintaining a portable, low-profile design. OBJECTIVE: To assess the clinical applicability of this 3D 4K-HD exoscope via first-in-man surgical use. METHODS: The operative workflow, functionality, and visual haptics of the 3D 4K-HD exoscope were assessed in a variety of microneurosurgical cases at 2 US centers...
November 26, 2018: Operative Neurosurgery (Hagerstown, Md.)
Evgenii G Belykh, Xiaochun Zhao, Claudio Cavallo, Michael A Bohl, Kaan Yagmurlu, Joseph L Aklinski, Vadim A Byvaltsev, Nader Sanai, Robert F Spetzler, Michael T Lawton, Peter Nakaji, Mark C Preul
Background We assessed a new robotic visualization platform with novel user-control features and compared its performance to the previous model of operative microscope. Methods In a neurosurgery research laboratory, we performed anatomical dissections and assessed robotic, exoscopic, endoscopic, fluorescence functionality. Usability and functionality were tested in the operating room over 1 year. Results The robotic microscope showed higher sensitivity for fluorescein sodium, higher detail in non-fluorescent background, and recorded/presented pictures with color quality similar to observation through the oculars...
July 30, 2018: Curēus
Brain D Sindelar, Vimal Patel, Shakeel Chowdhry, Julian E Bailes
Intracerebral hemorrhage (ICH) with or without intraventricular hemorrhage (IVH) is a highly morbid disease process due to the mass effect and secondary injury that occurs upon the surrounding brain. Historically, surgical evacuation has failed to demonstrate improved outcomes in comparison to standard medical therapy likely due to the significant brain trauma when accessing the clot. Recent minimally invasive techniques have proposed a way to improve outcomes by reducing this injury. We report here a 62-year-old male with ICH and IVH with acute neurological deterioration due to hydrocephalus was found to have no improvement following external ventricular drainage...
July 13, 2018: Curēus
David Mampre, Alexandra Bechtle, Kaisorn L Chaichana
OBJECTIVE: Posterior fossa tumor surgery is associated with a significant risk of complications, and the complications are typically more frequent compared with similar supratentorial surgeries. This study aimed to evaluate 1) the extent of resection and neurologic outcomes and 2) perioperative complications with use of minimally invasive approaches for intra-axial posterior fossa tumors from our case series. METHODS: All consecutive patients who underwent nonbiopsy surgery of a posterior fossa tumor using tubular retractors and exoscopic visualization from January 2016 to May 2018 were prospectively identified and included...
November 2018: World Neurosurgery
Kevin Kwan, Julia R Schneider, Victor Du, Lukas Falting, John A Boockvar, Jonathan Oren, Mitchell Levine, David J Langer
BACKGROUND: The operative microscope has significantly advanced modern neurosurgical spine surgery but continues to be limited by high costs, suboptimal optics, poor ergonomics, and difficulties with maneuverability. We believe the novel 4K high-definition (4K-HD) 3-dimensional (3D) exoscope (EX), may improve the surgical corridor through advancements in illumination, ergonomics, magnification, and depth of field and has the potential to be utilized in neurosurgical education and training...
August 14, 2018: Operative Neurosurgery (Hagerstown, Md.)
Evgenii Belykh, Laeth George, Xiaochun Zhao, Alessandro Carotenuto, Leandro Borba Moreira, Kaan Yağmurlu, Baran Bozkurt, Vadim A Byvaltsev, Peter Nakaji, Mark C Preul
Background: Extracranial-intracranial bypass is a challenging procedure that requires special microsurgical skills and an operative microscope. The exoscope is a tool for neurosurgical visualization that provides view on a heads-up display similar to an endoscope, but positioned external to the operating field, like a microscope. The authors carried out a proof-of-concept study evaluating the feasibility and effectiveness of performing microvascular bypass using various new exoscopic tools...
2018: Surgical Neurology International
Joshua Bakhsheshian, Ben A Strickland, Christina Jackson, Kaisorn L Chaichana, Ronald Young, Gustavo Pradilla, Jefferson W Chen, Julian Bailes, Gabriel Zada
BACKGROUND: Recent advancements have aimed to optimize visualization and minimize insult to healthy cortical and subcortical tissue through the use of tubular-based retractors. OBJECTIVE: To investigate outcomes following resection of cerebral metastases using an integrated tubular retraction system with an exoscope and neuronavigation. METHODS: A multicenter retrospective analysis of surgical outcomes in consecutive patients who underwent resection of a brain metastasis using a tubular retraction system and exoscope was performed...
April 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
Rajiv Iyer, Kaisorn L Chaichana
BACKGROUND AND STUDY AIMS/OBJECTIVE:  Deep-seated high-grade gliomas (HGGs) represent a unique surgical challenge because they reside deep to critical cortical and subcortical structures and infiltrate functional areas of the brain. Therefore, accessing and resecting these tumors can often be challenging and associated with significant morbidity. We describe the use of minimally invasive approaches to access deep-seated HGGs to achieve extensive resections while minimizing surgical morbidity...
July 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Kelly Gassie, Olindi Wijesekera, Kaisorn L Chaichana
Deep-seated, subcortical tumors represent a surgical challenge. The traditional approach to these lesions involve large craniotomies, fixed retractor systems, and extensive white matter dissection, each with their own associated morbidity. We describe our experience with the use of tubular retractors for accessing these deep-seated lesions. Fifty consecutive patients operated on for an intra-axial brain tumor (both biopsies and resection) from January 2016 to December 2017 by a single surgeon using tubular retractors with exoscopic visualization were prospectively identified and included in this consecutive case series...
April 18, 2018: Journal of Neurosurgical Sciences
Thomas Beez, Christopher Munoz-Bendix, Kerim Beseoglu, Hans-Jakob Steiger, Sebastian A Ahmadi
The ideal visualization tools in microneurosurgery should provide magnification, illumination, wide fields of view, ergonomics, and unobstructed access to the surgical field. The operative microscope was the predominant innovation in modern neurosurgery. Recently, a high-definition three-dimensional (3D) exoscope was developed. We describe the first applications in pediatric neurosurgery. The VITOM 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany) was used in pediatric microneurosurgical operations, along with an OPMI PENTERO operative microscope (Carl Zeiss AG, Jena, Germany)...
January 24, 2018: Curēus
Joham Choque-Velasquez, Roberto Colasanti, Juhani Collan, Riina Kinnunen, Behnam Rezai Jahromi, Juha Hernesniemi
OBJECTIVE: Microsurgical skills and eye-hand coordination need continuous training to be developed and refined. However, well-equipped microsurgical laboratories are not so widespread as their setup is expensive. Herein, we present a novel microsurgical training system that requires a high-resolution personal computer screen, smartphones, and virtual reality glasses. METHODS: A smartphone placed on a holder at a height of about 15-20 cm from the surgical target field is used as the webcam of the computer...
April 2018: World Neurosurgery
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