Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma
Abstract. 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-defini...
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Format: | Article |
Language: | English |
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Wolters Kluwer
2020-06-01
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Series: | Chinese Medical Journal |
Online Access: | http://journals.lww.com/10.1097/CM9.0000000000000818 |
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doaj-990f8d78c7e643afbbbe7f877af67a65 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xin Chen Xiang-Liang Gao Yan Chai Ming-Ming Shi Jian-Ning Zhang Shu-Yuan Yue Xiu-Yuan Hao |
spellingShingle |
Xin Chen Xiang-Liang Gao Yan Chai Ming-Ming Shi Jian-Ning Zhang Shu-Yuan Yue Xiu-Yuan Hao Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma Chinese Medical Journal |
author_facet |
Xin Chen Xiang-Liang Gao Yan Chai Ming-Ming Shi Jian-Ning Zhang Shu-Yuan Yue Xiu-Yuan Hao |
author_sort |
Xin Chen |
title |
Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma |
title_short |
Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma |
title_full |
Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma |
title_fullStr |
Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma |
title_full_unstemmed |
Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma |
title_sort |
use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma |
publisher |
Wolters Kluwer |
series |
Chinese Medical Journal |
issn |
0366-6999 2542-5641 |
publishDate |
2020-06-01 |
description |
Abstract. 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. |
url |
http://journals.lww.com/10.1097/CM9.0000000000000818 |
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doaj-990f8d78c7e643afbbbe7f877af67a652020-12-02T07:58:30ZengWolters KluwerChinese Medical Journal0366-69992542-56412020-06-01133111292129710.1097/CM9.0000000000000818202006050-00005Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannomaXin Chen0Xiang-Liang Gao1Yan Chai2Ming-Ming Shi3Jian-Ning Zhang4Shu-Yuan Yue5Xiu-Yuan Hao6Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin 300052, China.Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin 300052, China.Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin 300052, China.Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin 300052, China.Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin 300052, China.Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin 300052, China.Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin Neurological Institute, Key Laboratory of Post-trauma Neuro-repair and Regeneration in Central Nervous System, Ministry of Education, Tianjin Key Laboratory of Injuries, Variations and Regeneration of Nervous System, Tianjin 300052, China.Abstract. 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.http://journals.lww.com/10.1097/CM9.0000000000000818 |