Martina Piloni1, Michele Bailo2, Filippo Gagliardi2, Pietro Mortini2. 1. Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy. Electronic address: piloni.martina@hsr.it. 2. Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.
Abstract
BACKGROUND: Magnified intraoperative visualization is of paramount importance during microsurgical procedures. Although the introduction of the operating microscope represented one of the most relevant innovations in modern neurosurgery, surgical vision and maneuverability can be limited in cases of unfavorable angles of attack. In these situations, the placement of the operating microscope could be difficult and determine a significant discomfort to the surgeon. In the last decades, exoscopes have been introduced as alternative tools to provide optimal ergonomics by decoupling the line of sight of the surgeon from the binocular lenses. However, exoscopic platforms entail interim manual adjustments of camera position and setting. To overcome this limitation, robotic-assisted digital microscopy has been developed. We report our preliminary experience with RoboticScope to investigate the feasibility and safety of this novel digital system for intraoperative magnification. METHODS: In September 2020, RoboticScope was used to perform three cranial procedures for the resection of brain tumors. The surgeon's opinion was recorded to evaluate the quality of intraoperative vision, safety and efficacy of surgical maneuverability, and personal comfort. RESULTS: RoboticScope provided remarkable advantages in terms of enhanced workflow efficacy and increased comfort of the surgeon during the microsurgical phase of the cranial procedures. The overall quality of intraoperative digital imaging was rated not inferior to traditional optical microscopes. CONCLUSIONS: RoboticScope is a promising device, which may represent a valuable alternative to conventional tools for intraoperative visualization in the resection of intracranial tumors.
BACKGROUND: Magnified intraoperative visualization is of paramount importance during microsurgical procedures. Although the introduction of the operating microscope represented one of the most relevant innovations in modern neurosurgery, surgical vision and maneuverability can be limited in cases of unfavorable angles of attack. In these situations, the placement of the operating microscope could be difficult and determine a significant discomfort to the surgeon. In the last decades, exoscopes have been introduced as alternative tools to provide optimal ergonomics by decoupling the line of sight of the surgeon from the binocular lenses. However, exoscopic platforms entail interim manual adjustments of camera position and setting. To overcome this limitation, robotic-assisted digital microscopy has been developed. We report our preliminary experience with RoboticScope to investigate the feasibility and safety of this novel digital system for intraoperative magnification. METHODS: In September 2020, RoboticScope was used to perform three cranial procedures for the resection of brain tumors. The surgeon's opinion was recorded to evaluate the quality of intraoperative vision, safety and efficacy of surgical maneuverability, and personal comfort. RESULTS: RoboticScope provided remarkable advantages in terms of enhanced workflow efficacy and increased comfort of the surgeon during the microsurgical phase of the cranial procedures. The overall quality of intraoperative digital imaging was rated not inferior to traditional optical microscopes. CONCLUSIONS: RoboticScope is a promising device, which may represent a valuable alternative to conventional tools for intraoperative visualization in the resection of intracranial tumors.
Authors: Matthias M Aitzetmüller; Marie-Luise Klietz; Alexander F Dermietzel; Tobias Hirsch; Maximilian Kückelhaus Journal: J Clin Med Date: 2022-06-13 Impact factor: 4.964