Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun 1;16(6):717-725.
doi: 10.1093/ons/opy320.

First-in-Man Clinical Experience Using a High-Definition 3-Dimensional Exoscope System for Microneurosurgery

Alexander A Khalessi  1 , Ralph Rahme  2   3 , Robert C Rennert  1 , Pia Borgas  2 , Jeffrey A Steinberg  1 , Timothy G White  2 , David R Santiago-Dieppa  1 , John A Boockvar  2 , Dustin Hatefi  1 , J Scott Pannell  1 , Michael Levy  1 , David J Langer  2
Affiliations

First-in-Man Clinical Experience Using a High-Definition 3-Dimensional Exoscope System for Microneurosurgery

Alexander A Khalessi et al. Oper Neurosurg. .

Abstract

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.

Results: Nineteen microneurosurgical procedures in 18 patients were performed exclusively using the 3D 4K-HD exoscope. Pathologies treated included 4 aneurysms, 3 cavernous malformations (1 with intraoperative electrocorticography), 2 arteriovenous malformations, 1 foramen magnum meningioma, 1 convexity meningioma, 1 glioma, 1 occipital cyst, 1 chiari malformation, 1 carotid endarterectomy, 1 subdural hematoma, 1 anterior cervical discectomy and fusion, and 2 lumbar laminectomies. All patients experienced good surgical and clinical outcomes. Similar to preclinical assessments, the 3D 4K-HD exoscope provided an immersive 3D surgical experience for the primary surgeon, assistants, and trainees. The small exoscope frame, large depth of field, and hand/foot pedal controls improved exoscope mobility, decreased need to re-focus, and provided unobstructed operative corridors. Flexible positioning of the camera allows the surgeon's posture to be kept in a neutral position with uncompromised viewing angles.

Conclusion: The first-in-man clinical experience with the 3D 4K-HD exoscope confirms its excellent optics and ergonomics for the entire operative team, with high workflow adaptability for a variety of microneurosurgical cases. Expanded clinical use of the 3D 4K-HD exoscope is justified.

Keywords: 3D visualization; Ergonomics; Exoscope; Microneurosurgery; Neurosurgical education; Operating microscope.

PubMed Disclaimer

Comment in

Publication types

MeSH terms

LinkOut - more resources