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Exoscope-assisted temporal bone resection: operative videos of the lateral and total techniques 外镜辅助下的颞骨切除术：侧切和全切技术的手术视频
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23135
Alejandra Rodas, Edoardo Porto, J. R. Revuelta Barbero, Jackson Vuncannon, Youssef M. Zohdy, Biren Khimji Patel, Gustavo Pradilla, C. Solares
{"title":"Exoscope-assisted temporal bone resection: operative videos of the lateral and total techniques","authors":"Alejandra Rodas, Edoardo Porto, J. R. Revuelta Barbero, Jackson Vuncannon, Youssef M. Zohdy, Biren Khimji Patel, Gustavo Pradilla, C. Solares","doi":"10.3171/2023.10.focvid23135","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23135","url":null,"abstract":"Skull base malignancies arising from the parotid gland, skin, or external auditory canal (EAC) can potentially involve the temporal bone. Management of these invasive tumors represents a true challenge considering the critical neurovascular relationships. Exoscope-assisted temporal bone resection (TBR) plays a crucial role in addressing such malignancies. The extent of disease is evaluated using the Pittsburgh staging system, which then guides the boundaries of resection. Lateral TBR (LTBR) relies on removal of the EAC and lateral ossicles and is generally appropriate for stage T1 and T2 tumors. Total TBR (TTBR) is reserved for high-grade tumors involving the petrous apex. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23135","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"141 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139128345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exoscopic supraorbital approach for a suprasellar craniopharyngioma 眶上外镜法治疗鞍上颅咽管瘤
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23140
Arpan A. Patel, Erion Júnior de Andrade, Shaarada R Srivatsa, P. Recinos
{"title":"Exoscopic supraorbital approach for a suprasellar craniopharyngioma","authors":"Arpan A. Patel, Erion Júnior de Andrade, Shaarada R Srivatsa, P. Recinos","doi":"10.3171/2023.10.focvid23140","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23140","url":null,"abstract":"The authors present an operative video of a supraorbital craniotomy for resection of a suprasellar, supradiaphragmatic craniopharyngioma. The patient is a 62-year-old female who presented with 3 months of blurry vision secondary to a 2.5-cm suprasellar mass causing compression on the optic nerve. Supraorbital craniotomy was selected due to the supradiaphragmatic location of the tumor and the subsequent disadvantages, including CSF leakage, of other approaches such as the endoscopic endonasal approach. The operative video emphasizes optimizing operating room (OR) setup to improve surgeon ergonomics and comfort. The patient underwent an uncomplicated gross-total resection with subsequent discharge home the day after surgery. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23140","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"2 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Use of a 3D exoscope in microvascular decompression of the trigeminal nerve root 三维外窥镜在三叉神经根微血管减压术中的应用
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23149
J. Herta, Karl Rössler, C. Dorfer
{"title":"Use of a 3D exoscope in microvascular decompression of the trigeminal nerve root","authors":"J. Herta, Karl Rössler, C. Dorfer","doi":"10.3171/2023.10.focvid23149","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23149","url":null,"abstract":"For microvascular decompression surgery, adequate visualization of the trigeminal nerve root is essential. Several visualization techniques with operating microscopes, endoscopes, a combination of both, and exoscopes have been described. In this video, the authors use a 4K 3D exoscope (ORBEYE) as it offers superb optical image quality with a high degree of magnification and illumination in the cerebellopontine angle. Other advantages are surgeon ergonomics, a very good depth of field for the entire operating team, and potentially evolving visualization technologies like narrow-band imaging—essential points for microvascular decompression surgery where the aim is to create the best possible visibility in a narrow corridor. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23149","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"49 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Initial institutional experience using a robotic arm–enabled 4K 3D exoscope in neurosurgical operations 在神经外科手术中使用机械臂 4K 3D 外窥镜的初步机构经验
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23150
J. Khalifeh, Ali Karim Ahmed, Wataru Ishida, J. Materi, Anita L Kalluri, D. Lubelski, T. Witham, Nicholas Theodore, Debraj Mukherjee, Judy Huang
{"title":"Initial institutional experience using a robotic arm–enabled 4K 3D exoscope in neurosurgical operations","authors":"J. Khalifeh, Ali Karim Ahmed, Wataru Ishida, J. Materi, Anita L Kalluri, D. Lubelski, T. Witham, Nicholas Theodore, Debraj Mukherjee, Judy Huang","doi":"10.3171/2023.10.focvid23150","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23150","url":null,"abstract":"The extracorporeal telescope (exoscope) presents a novel digital camera system as a versatile alternative to traditional optical microscopy for microsurgery and minimally invasive neurosurgical operations. Recent innovations in exoscope technology offer 4K-definition multiscreen outputs, pneumatic robot arms, 3-dimensional depth perception, and greater illumination, focus, and magnification powers for enhanced intraoperative visualization. The authors present their initial institutional experience using a robotic arm–enabled 4K 3D exoscope in a variety of cranial and spinal neurosurgical operations, namely Chiari decompression, microvascular decompression for trigeminal neuralgia, anterior cervical discectomy, and lumbar decompressions. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23150","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"55 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exoscope-assisted resection of a recurrent left frontal pilocytic astrocytoma 外镜辅助切除复发性左额叶朝天性星形细胞瘤
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23158
Sanjeev Sreenivasan, Danielle Golub, Karen Black, Michael Schulder
{"title":"Exoscope-assisted resection of a recurrent left frontal pilocytic astrocytoma","authors":"Sanjeev Sreenivasan, Danielle Golub, Karen Black, Michael Schulder","doi":"10.3171/2023.10.focvid23158","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23158","url":null,"abstract":"An exoscope strengthens the armamentarium of a neurosurgeon by improving visualization and surgeon ergonomics, reducing surgeon discomfort, and improving coordination among the surgical team. A 23-year-old male patient developed focal seizures and weakness affecting his right arm that was attributable to a recurrent left frontal lesion. Despite two craniotomies at an 8-year interval, chemotherapy, and radiation, the tumor continued to progress. In this video, the authors demonstrate resection of a recurrent left frontal pilocytic astrocytoma with the assistance of an exoscope, neuronavigation, and neuromonitoring. The exoscope can enhance surgical resectability while smoothening the surgical workflow. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23158","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"53 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Selective dorsal rhizotomy using a 3D high definition exoscope 使用三维高清外窥镜进行选择性背根切断术
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23105
Jia Xu Lim, W. Seow, Zhi Min Ng, Sharon Y. Y. Low
{"title":"Selective dorsal rhizotomy using a 3D high definition exoscope","authors":"Jia Xu Lim, W. Seow, Zhi Min Ng, Sharon Y. Y. Low","doi":"10.3171/2023.10.focvid23105","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23105","url":null,"abstract":"Selective dorsal rhizotomy (SDR) is an established neurosurgical technique for children with spastic diplegia secondary to cerebral palsy. Meticulous intraoperative testing of individual nerve roots with electromyography in tandem with the on-site neurorehabilitation team is recommended for good clinical outcomes. The standard approach requires the neurosurgeons to spend extended time under the traditional operating microscope. In this video, the authors describe the use of a 3D exoscope system for SDR. Overall, the 3D exoscope improves ergonomics and reduces musculoskeletal fatigue for the operating neurosurgeons. Furthermore, it provides excellent visualization of important structures, allowing safe and efficient completion of the procedure. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23105","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"14 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139127743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Can exoscope improve brain AVMs surgery? 外窥镜能否改善脑动静脉畸形手术？
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23114
S. Tola, Federico Capelli, Alessandro Della Puppa
{"title":"Can exoscope improve brain AVMs surgery?","authors":"S. Tola, Federico Capelli, Alessandro Della Puppa","doi":"10.3171/2023.10.focvid23114","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23114","url":null,"abstract":"The advantages of the surgical view provided by the exoscope have been described before, although reports of its application to brain arteriovenous malformation (AVM) surgery are lacking. The ampler field of view and magnification up to ×24 allow for enhanced visualization during microsurgical procedures. Furthermore, the live visualization provided by indocyanine green video angiography (ICG-VA) helps emphasize the hemodynamics of AVMs, even allowing the detection of possible residual vein arterialization as an indirect expression of nidal remnants. With this illustrative video showing the resection of a hemorrhagic right frontoinsular Spetzler-Martin grade III AVM, the authors describe the technical implications of exoscope brain AVM surgery using the Olympus ORBEYE 4K-3D, with a final focus on ICG-VA as an asset. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23114","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"58 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139128161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exoscopic microvascular decompression for hemifacial spasm and trigeminal neuralgia 外窥镜微血管减压术治疗半面痉挛和三叉神经痛
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23122
Hiroki Toda, Hirokuni Hashikata, Ryota Ishibashi
{"title":"Exoscopic microvascular decompression for hemifacial spasm and trigeminal neuralgia","authors":"Hiroki Toda, Hirokuni Hashikata, Ryota Ishibashi","doi":"10.3171/2023.10.focvid23122","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23122","url":null,"abstract":"The 4K 3D exoscope system is becoming increasingly used in neurosurgery. Its 3D ultra-high-definition image is valuable in identifying and dissecting the delicate neural and vascular structures during microvascular decompression. In this video, the authors describe several nuances and details to perform the exoscopic microvascular decompression, including the exoscope layout and the modified supine position. Several illustrative case presentations highlight the benefits of exoscopic surgery. The authors’ exoscopic microvascular decompression series of 159 patients showed noninferior surgical outcomes compared to the operative microscope with no significant increase in surgical risk. In conclusion, an exoscope can be a practical alternative to performing microvascular decompression. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23122","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"56 38","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Occipital-interhemispheric transtentorial pineal mass resection 枕部-大脑半球间横隔松果体肿块切除术
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23161
Grant Arzumanov, Seung W. Jeong, Bhavika Gupta, Rocco Dabecco, Jose Sandoval, Matthew J. Shepard, Jody Leonardo, Alexander Yu
{"title":"Occipital-interhemispheric transtentorial pineal mass resection","authors":"Grant Arzumanov, Seung W. Jeong, Bhavika Gupta, Rocco Dabecco, Jose Sandoval, Matthew J. Shepard, Jody Leonardo, Alexander Yu","doi":"10.3171/2023.10.focvid23161","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23161","url":null,"abstract":"The occipital approach for pineal tumors was first described by James Poppen in 1966. Since then, it has been widely used for accessing deep-seated tumors as it offers a wider surgical view than the supracerebellar transtentorial approach. This video demonstrates the technical nuances of the occipital transtentorial approach and the exoscopic dissection of a pineal gland tumor in a 66-year-old male. Use of the exoscope over the microscope provides certain ergonomic advantages and improves surgical workflow, as demonstrated here. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23161","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"88 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139125109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exoscopic resection of a parasagittal atypical meningioma 矢状旁非典型脑膜瘤的外镜切除术
Neurosurgical focus: Video Pub Date : 2024-01-01 DOI: 10.3171/2023.10.focvid23164
Alejandro Carrasquilla, Artur Zgurov, Mira Salih, Chi Le, Stavros Matsoukas, Rui Feng, Alexander J Schupper, Constantinos G. Hadjipanayis
{"title":"Exoscopic resection of a parasagittal atypical meningioma","authors":"Alejandro Carrasquilla, Artur Zgurov, Mira Salih, Chi Le, Stavros Matsoukas, Rui Feng, Alexander J Schupper, Constantinos G. Hadjipanayis","doi":"10.3171/2023.10.focvid23164","DOIUrl":"https://doi.org/10.3171/2023.10.focvid23164","url":null,"abstract":"This video demonstrates use of the Synaptive 3D exoscope to enhance complex meningioma resection. The patient was a 58-year-old female who presented with new-onset seizures. Workup revealed a parasagittal meningioma over the bilateral cortices. She was started on 750 mg of Keppra twice daily and tapered dexamethasone and discharged. MR venography demonstrated segmental occlusion of the superior sagittal sinus. She then underwent a diagnostic angiogram and tumor Onyx embolization of the bilateral middle meningeal artery feeders. She then underwent a craniotomy for meningioma resection using 3D exoscope guidance. She awoke with a stable examination in the intensive care unit and worked with physical therapy on postoperative day 1. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23164","PeriodicalId":74299,"journal":{"name":"Neurosurgical focus: Video","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139129490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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