2023 Volume 51 Issue 5 Pages 397-404
Background: Exoscopes have recently been introduced in the neurosurgical field and their usefulness has been reported. Exoscopes can improve surgical field visibility with 4K-3D monitors and alleviate the physical strain associated with surgeons’ neutral posture. Herein, we report our early experiences with exoscopic aneurysm surgery at our facility.
Methods: The study sample included 134 patients with unruptured intracranial aneurysms who underwent surgical procedures between January 2021 and August 2022. Two patients who did not undergo surgical clipping were excluded. The baseline characteristics, setup time, operative time, surgical complications, and clinical outcomes were compared between exoscopic and microscopic repair.
Results: Seventy-five patients (55.1%) underwent exoscopic clipping. The patient characteristics were similar between the two groups. There were no significant differences in the setup time (63 min vs. 62 min; P=0.120), operative time (295 min vs. 304 min, P=0.990), rate of surgical complications (5.3% vs. 3.3%, P=0.691), or favorable outcomes (97.3% vs. 95.1%, P=0.657) between the two groups. In the postoperative questionnaire evaluation, the exoscope received higher scores in terms of “image quality”(78.9%), “brightness” (84.2%), “operability” (73.7%), and “education” (57.9%). In contrast, the conventional microscope received higher scores in terms of “assistant work” (73.7%).
Conclusion: The benefits of the exoscope were high image quality, expanded view with digital zoom, a compact body, and comfortable resting position, which led to reduced fatigue among neurosurgeons. The exoscope was useful for surgical clipping, and the clinical outcomes were acceptable.
