PDF(Pubmed)
Abstract：
Improvement of visualization tools in neurosurgery such as the exoscope has raised the question of how this technology compares to the conventional microscope for surgeon ergonomics, discomfort, and patient outcomes. Exoscopes have the advantage of greater optical zoom, resolution, and illumination at a lower light intensity. Heads-up display for both the primary surgeon and other assistants permits neutral positioning of the surgeons while placing the camera in more angled positions. In a survey sample, this study assesses the surgeon experience utilizing 3D exoscope in general neurosurgery cases.
Data weere recorded by 8 surgeons at 5 separate hospitals utilizing a mobile phone application survey. Surgeons recorded information about case type, intraoperative clinical outcomes such as blood loss and extent of resection, whether fluorescence visualization was used, as well as surgeon pain when compared to matched cases using conventional tools.
A total of 155 neurosurgical cases were recorded in this multisite study, including 72% cranial cases and 28% spinal cases. Of the cranial cases, 76% were brain tumor resections (31% of which were brain metastases). Surgeons reported significantly less neck (P < 0.0001) and back (P < 0.0001) pain in cases when using the robotic exoscope compared with the conventional microscope or surgical loupes. Surgeons did not convert to a microscope in any case.
The exoscope provides excellent delineation of tissue with high resolution. Surgeon pain was markedly reduced with the robotic exoscope when compared with conventional technology, which may reduce work-related injury and fatigue, potentially leading to better patient outcomes.
Data weere recorded by 8 surgeons at 5 separate hospitals utilizing a mobile phone application survey. Surgeons recorded information about case type, intraoperative clinical outcomes such as blood loss and extent of resection, whether fluorescence visualization was used, as well as surgeon pain when compared to matched cases using conventional tools.
A total of 155 neurosurgical cases were recorded in this multisite study, including 72% cranial cases and 28% spinal cases. Of the cranial cases, 76% were brain tumor resections (31% of which were brain metastases). Surgeons reported significantly less neck (P < 0.0001) and back (P < 0.0001) pain in cases when using the robotic exoscope compared with the conventional microscope or surgical loupes. Surgeons did not convert to a microscope in any case.
The exoscope provides excellent delineation of tissue with high resolution. Surgeon pain was markedly reduced with the robotic exoscope when compared with conventional technology, which may reduce work-related injury and fatigue, potentially leading to better patient outcomes.
摘要：
背景：神经外科手术中可视化工具的改进，例如出镜，提出了一个问题，即该技术与外科医生人体工程学的常规显微镜相比如何，不适,和患者结果。出射镜具有更大的光学变焦优势，决议,和照明在较低的光强度。主外科医生和其他助手的平视显示器允许外科医生的中立定位,同时将相机放置在更多角度的位置。在调查样本中，这项研究评估了在普通神经外科病例中使用3D外镜检查的外科医生经验。
方法：数据由四家独立医院的七名外科医生利用手机应用调查记录。外科医生记录了病例类型的信息，术中临床结果，如失血量和切除程度，是否使用荧光可视化，以及外科医生的疼痛与使用常规工具的匹配病例相比。
结果：这项多中心研究记录了155例神经外科病例，包括72％的颅骨病例和28％的脊柱病例。在颅骨病例中，76％为脑肿瘤切除术（其中31％为脑转移）。与常规显微镜或手术放大镜相比，在使用机器人外镜时，外科医生报告的颈部（p<0.0001）和背部（p<0.0001）疼痛明显减少。在任何情况下，外科医生都没有转换为显微镜。
结论：出镜以高分辨率提供了出色的组织轮廓。与传统技术相比，机器人手术外镜显着减少了外科医生的疼痛，这可以减少与工作有关的伤害和疲劳，可能导致更好的患者结果。
方法：数据由四家独立医院的七名外科医生利用手机应用调查记录。
结果：这项多中心研究记录了155例神经外科病例，
结论：出镜以高分辨率提供了出色的组织轮廓。
