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
Background Brain tumor surgery has been using operative microscope for years.Recently,thanks to developments in surgical technology with procedures performed on head-up displays,exoscopes have been introduced as an al...Background Brain tumor surgery has been using operative microscope for years.Recently,thanks to developments in surgical technology with procedures performed on head-up displays,exoscopes have been introduced as an alternative to microscopic vision.Case presentation We present a case of a 46-year-old patient with a low-grade glioma recurrence of the right gyrus cinguli removed with a contralateral transfalcine approach using an exoscope(ORBEYE 4K-three-dimensional(3D)exoscope,Sony Olympus Medical Solutions Inc.,Tokyo,Japan).The operating room setup for this approach is illustrated.During the procedure,the surgeon was seated with head and back in an upright position,while the camera was aligned with the surgical corridor.The exoscope provided detailed,high-quality 4K-3D images of the anatomical structures and optimal depth perception,making surgery accurate and precise.At the end of the resection,an intraoperative MRI scan showed complete removal of the lesion.The patient was discharged on postoperative day 4 with an excellent performance on neuropsychological examination.Conclusions In this clinical case the contralateral approach was favorable because the glioma was located close to the midline and because it offered a straight path to the tumor,minimizing retraction on the brain.The exoscope provided the surgeon with important advantages in terms of anatomical visualization and ergonomics during the entire procedure.展开更多
This study focuses on exoscopic analyses of detrital zircon grains of Archean and Paleoproterozoic age, contained in the sediments from the Niamey Neoproterozoic sandstones (Niamey region), with a view to confirming t...This study focuses on exoscopic analyses of detrital zircon grains of Archean and Paleoproterozoic age, contained in the sediments from the Niamey Neoproterozoic sandstones (Niamey region), with a view to confirming the sediments sources already proposed (Kénéma-Man domain for Archean-age zircons and Baoulé Mossi domain for Paleoproterozoic-age zircons). Exoscopic analysis reveals that Archean zircon grains are more corroded, with rounded to sub-rounded shapes, while Paleoproterozoic zircon grains are less corroded and mostly angular in shape. The strong corrosion of Archean zircon grains, implying long-distance transport, is consistent with the remoteness of the Kenema-Man domain which are the source these sediments. The fact that the Paleoproterozoic zircon grains show little or no wear implies a proximal source of sediments, corresponding to the Baoulé Mossi domain.展开更多
Free tissue transfer(FTT)is a cornerstone of head and neck reconstruction.Although rare,complications of FTT surgery can be devastating,including failed flap harvest,wound breakdown,or flap loss ultimately.Thus,modern...Free tissue transfer(FTT)is a cornerstone of head and neck reconstruction.Although rare,complications of FTT surgery can be devastating,including failed flap harvest,wound breakdown,or flap loss ultimately.Thus,modern microvascular surgeons bolster surgical and clinical expertise with a growing number of technological advances to optimize patient care and outcomes.These technologies can be applied in the preoperative,intraoperative,and postoperative period.Various preoperative imaging modalities can assist in selecting the optimal donor site and advanced perforator planning.Intraoperatively,novel technologies can assist with microvascular anastomoses,operative magnification and visualization,and assess free tissue perfusion.Postoperatively,routine clinical assessment can be augmented by a variety of adjunctive monitoring techniques designed to assess tissue health,arterial inflow and venous drainage.The overall ease and success of performing FTT can be improved by employing novel technologies at every phase of the surgical process.This article will expand upon established and upcoming technological advances and the existing literatures to support their use.展开更多
基金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.
文摘Background Brain tumor surgery has been using operative microscope for years.Recently,thanks to developments in surgical technology with procedures performed on head-up displays,exoscopes have been introduced as an alternative to microscopic vision.Case presentation We present a case of a 46-year-old patient with a low-grade glioma recurrence of the right gyrus cinguli removed with a contralateral transfalcine approach using an exoscope(ORBEYE 4K-three-dimensional(3D)exoscope,Sony Olympus Medical Solutions Inc.,Tokyo,Japan).The operating room setup for this approach is illustrated.During the procedure,the surgeon was seated with head and back in an upright position,while the camera was aligned with the surgical corridor.The exoscope provided detailed,high-quality 4K-3D images of the anatomical structures and optimal depth perception,making surgery accurate and precise.At the end of the resection,an intraoperative MRI scan showed complete removal of the lesion.The patient was discharged on postoperative day 4 with an excellent performance on neuropsychological examination.Conclusions In this clinical case the contralateral approach was favorable because the glioma was located close to the midline and because it offered a straight path to the tumor,minimizing retraction on the brain.The exoscope provided the surgeon with important advantages in terms of anatomical visualization and ergonomics during the entire procedure.
文摘This study focuses on exoscopic analyses of detrital zircon grains of Archean and Paleoproterozoic age, contained in the sediments from the Niamey Neoproterozoic sandstones (Niamey region), with a view to confirming the sediments sources already proposed (Kénéma-Man domain for Archean-age zircons and Baoulé Mossi domain for Paleoproterozoic-age zircons). Exoscopic analysis reveals that Archean zircon grains are more corroded, with rounded to sub-rounded shapes, while Paleoproterozoic zircon grains are less corroded and mostly angular in shape. The strong corrosion of Archean zircon grains, implying long-distance transport, is consistent with the remoteness of the Kenema-Man domain which are the source these sediments. The fact that the Paleoproterozoic zircon grains show little or no wear implies a proximal source of sediments, corresponding to the Baoulé Mossi domain.
文摘Free tissue transfer(FTT)is a cornerstone of head and neck reconstruction.Although rare,complications of FTT surgery can be devastating,including failed flap harvest,wound breakdown,or flap loss ultimately.Thus,modern microvascular surgeons bolster surgical and clinical expertise with a growing number of technological advances to optimize patient care and outcomes.These technologies can be applied in the preoperative,intraoperative,and postoperative period.Various preoperative imaging modalities can assist in selecting the optimal donor site and advanced perforator planning.Intraoperatively,novel technologies can assist with microvascular anastomoses,operative magnification and visualization,and assess free tissue perfusion.Postoperatively,routine clinical assessment can be augmented by a variety of adjunctive monitoring techniques designed to assess tissue health,arterial inflow and venous drainage.The overall ease and success of performing FTT can be improved by employing novel technologies at every phase of the surgical process.This article will expand upon established and upcoming technological advances and the existing literatures to support their use.
