Background::Extra-corporeal video telescope operating monitor system provides a necessary instrument to perform high-precision neurosurgical procedures that could substitute or supplement the traditional surgical micr...Background::Extra-corporeal video telescope operating monitor system provides a necessary instrument to perform high-precision neurosurgical procedures that could substitute or supplement the traditional surgical microscope.The present study was designed to evaluate a compact high-definition two-dimensional exoscope system for assisting in surgical removal of large vestibular schwannoma(VS),as an alternative to a binocular surgical microscope.Methods::Patients with Koos grade 3 and grade 4 VS undergoing surgery were enrolled in this prospective cohort study between January 2013 and June 2018.The demographics and tumor characteristics(size,Koos grade,composition[cystic or solid mass])were matched between the two groups of patients.The following outcome measurements were compared between the two groups:duration of surgery,volume of blood loss,extent of tumor resection,number of operating field adjustments,pre-and post-operative facial and cochlear nerve function evaluated at 3 months post-surgery,complications and surgeons’comfortability.Results::A total of 81 patients received tumor resection through the retrosigmoid approach under either an exoscope(cases,n=39)or a surgical microscope(control,n=42).Patients in the two groups had comparable tumor location(P=0.439),Koos grading(P=0.867),and composition(P=0.891).While no significant differences in the duration of surgery(P=0.172),extent of tumor resection(P=0.858),facial function(P=0.838),and hearing ability(P=1.000),patients operated on under an exoscope had less blood loss(P=0.036)and a fewer field adjustments(P<0.001).Both primary and assistant surgeons reported a high level of comfort operating under the exoscope(P=0.001 and P<0.001,respectively).Conclusions::The compact high-definition two-dimensional exoscope system provides a safe and efficient means to assist in removing large VSs,as compared to a surgical microscope.After the acquaintance with a visual perception through a dynamic hint and stereoscopically viewing corresponding to the motion parallax,the exoscope system provided a comfortable,high-resolution visualization without compromising operational efficiency and patient safety.展开更多
基金This work was supported by grants from the National Natural Science Foundation of China(No.81671902)the Project of Tianjin Applied Basic and Cutting-edge Technological Research(No.17JCYBJC25200)by the Tianjin Health Care Elite Prominent Young Doctor Development Program and Young,and middle-aged innovative talent training program.
文摘Background::Extra-corporeal video telescope operating monitor system provides a necessary instrument to perform high-precision neurosurgical procedures that could substitute or supplement the traditional surgical microscope.The present study was designed to evaluate a compact high-definition two-dimensional exoscope system for assisting in surgical removal of large vestibular schwannoma(VS),as an alternative to a binocular surgical microscope.Methods::Patients with Koos grade 3 and grade 4 VS undergoing surgery were enrolled in this prospective cohort study between January 2013 and June 2018.The demographics and tumor characteristics(size,Koos grade,composition[cystic or solid mass])were matched between the two groups of patients.The following outcome measurements were compared between the two groups:duration of surgery,volume of blood loss,extent of tumor resection,number of operating field adjustments,pre-and post-operative facial and cochlear nerve function evaluated at 3 months post-surgery,complications and surgeons’comfortability.Results::A total of 81 patients received tumor resection through the retrosigmoid approach under either an exoscope(cases,n=39)or a surgical microscope(control,n=42).Patients in the two groups had comparable tumor location(P=0.439),Koos grading(P=0.867),and composition(P=0.891).While no significant differences in the duration of surgery(P=0.172),extent of tumor resection(P=0.858),facial function(P=0.838),and hearing ability(P=1.000),patients operated on under an exoscope had less blood loss(P=0.036)and a fewer field adjustments(P<0.001).Both primary and assistant surgeons reported a high level of comfort operating under the exoscope(P=0.001 and P<0.001,respectively).Conclusions::The compact high-definition two-dimensional exoscope system provides a safe and efficient means to assist in removing large VSs,as compared to a surgical microscope.After the acquaintance with a visual perception through a dynamic hint and stereoscopically viewing corresponding to the motion parallax,the exoscope system provided a comfortable,high-resolution visualization without compromising operational efficiency and patient safety.
