PDF(Pubmed)
Abstract：
The conventional microscope has the disadvantage of a potentially unergonomic posture for the surgeon, which can affect performance. Monitor-based exoscopes could provide a more ergonomic posture, as already shown in pre-clinical studies. The aim of this study was to test the usability and comfort of a novel head-mounted display (HMD)-based exoscope on spinal surgical approaches in a simulated OR setting. A total of 21 neurosurgeons naïve to the device were participated in this prospective trial. After a standardized training session with the device, participants were asked to perform a single-level thoracolumbar decompression surgery on human cadavers using the exoscope. Subsequently, all participants completed a comfort and safety questionnaire. For the objective evaluation of the performance, all interventions were videotaped and analyzed. Twelve men and nine women with a mean age of 34 (range: 24-57) were participating in the study. Average time for decompression was 15 min (IqR 9.6; 24.2); three participants (14%) terminated the procedure prematurely. In these dropouts, a significantly higher incidence of back/neck pain (p = 0.002 for back, p = 0.046 for neck pain) as well as an increased frequency of HMD readjustments (p = 0.045) and decreased depth perception (p = 0.03) were documented. Overall, the surgeons\' satisfaction with the exoscope was 84% (IqR 75; 100). Using a standardized, pre-interventional training, it is possible for exoscope-naïve surgeons to perform sufficient spinal decompression using the HMD-based exoscope with a high satisfaction. However, inaccurate HMD setup prior to the start of the procedure may lead to discomfort and unsatisfactory results.
摘要：
传统显微镜的缺点是外科医生的姿势可能不符合人体工程学，这会影响性能。基于监视器的外镜可以提供更符合人体工程学的姿势，正如临床前研究中已经显示的那样。这项研究的目的是在模拟OR设置的脊柱手术方法上测试基于新型头戴式显示器（HMD）的外镜的可用性和舒适性。共有21名对该装置幼稚的神经外科医生参加了这项前瞻性试验。在使用该设备进行标准化培训后，参与者被要求使用外镜对人体尸体进行单级胸腰椎减压手术.随后，所有参与者完成了舒适和安全问卷.为了客观评价业绩，对所有干预措施进行了录像和分析.12名男性和9名女性，平均年龄为34岁（范围：24-57岁）参与了这项研究。平均减压时间为15分钟（IqR9.6;24.2）；三名参与者（14％）过早终止手术。在这些辍学者中，背部/颈部疼痛的发生率明显更高（背部p=0.002，颈部疼痛p=0.046）以及HMD重新调整的频率增加（p=0.045）和深度感知降低（p=0.03）。总的来说,外科医生对外镜的满意度为84%(IqR75;100)。使用标准化的，介入前培训，这是可能的外科学的外科医生进行足够的脊柱减压使用HMD为基础的外科学器有很高的满意度。然而,在程序开始之前不准确的HMD设置可能导致不适和不令人满意的结果。
