id,collection,dc.contributor.author,dc.date.accessioned,dc.date.available,dc.date.issued,dc.description.abstract[],dc.identifier.uri,dc.language,dc.rights.uri,dc.subject.ddc,dc.subject[en],dc.title,dc.type,dcterms.accessRights.openaire,dcterms.bibliographicCitation.doi,dcterms.bibliographicCitation.journaltitle,dcterms.bibliographicCitation.number,dcterms.bibliographicCitation.originalpublishername,dcterms.bibliographicCitation.pageend,dcterms.bibliographicCitation.pagestart,dcterms.bibliographicCitation.pmid,dcterms.bibliographicCitation.volume,dcterms.isPartOf.eissn,dcterms.isPartOf.issn,refubium.affiliation,refubium.funding,refubium.resourceType.isindependentpub "f0cd719b-0a0f-40cc-84b3-f35b2fe78a95","fub188/15","Roethe, Anna L.||Landgraf, Philipp||Schröder, Torsten||Misch, Martin||Vajkoczy, Peter||Picht, Thomas","2022-06-23T09:23:48Z","2022-06-23T09:23:48Z","2020","Background: Promoting a disruptive innovation in microsurgery, exoscopes promise alleviation of physical strain and improved image quality through digital visualization during microneurosurgical interventions. This study investigates the impact of a novel 3D4k hybrid exoscope (i.e., combining digital and optical visualization) on surgical performance and team workflow in preclinical and clinical neurosurgical settings. Methods: A pre-clinical workshop setting has been developed to assess usability and implementability through skill-based scenarios (neurosurgical participants n = 12). An intraoperative exploration in head and spine surgery (n = 9) and a randomized clinical study comparing ocular and monitor mode in supratentorial brain tumor cases (n = 20) followed within 12 months. Setup, procedure, case characteristics, surgical performance, and user experience have been analyzed for both ocular group (OG) and monitor group (MG). Results: Brain tumor cases using frontal, frontoparietal, or temporal approaches have been identified as favorable use cases for introducing exoscopic neurosurgery. Mean monitor distance and angle were 180 cm and 10°. Surgical ergonomics when sitting improved significantly in MG compared with OG (P = .03). Hand-eye coordination required familiarization in MG. Preclinical data showed a positive correlation between lateral camera inclination and impact on hand-eye coordination (rs = 0.756, P = .01). There was no significant added surgical time in MG. Image quality in current generation 3D4k monitors has been rated inferior to optic visualization yet awaits updates. Conclusions: The hybrid exoscopic device can be integrated into established neurosurgical workflows. Currently, exoscopic interventions seem most suited for cranial tumor surgery in lesions that are not deep-seated. Ergonomics improve in monitor mode compared to conventional microsurgery.","https://refubium.fu-berlin.de/handle/fub188/35386||http://dx.doi.org/10.17169/refubium-35102","eng","https://creativecommons.org/licenses/by/4.0/","600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit","Brain tumor||Digital innovation||Exoscope||Intraoperative visualization||Technology evaluation","Monitor-based exoscopic 3D4k neurosurgical interventions: a two-phase prospective-randomized clinical evaluation of a novel hybrid device","Wissenschaftlicher Artikel","open access","10.1007/s00701-020-04361-2","Acta Neurochirurgica","12","Springer Nature","2961","2949","32424568","162","0942-0940","0001-6268","Charité - Universitätsmedizin Berlin","Springer Nature DEAL","no"