Evaluation of 3D Robotic-Guided Exoscopic Visualization in Microneurosurgery

Area of Science:

• Neurosurgery
• Surgical Technology
• Medical Devices

Background:

• The operating microscope (OM) is the standard for microneurosurgery.
• Three-dimensional (3D) exoscopes represent a novel advancement in surgical visualization.
• This technology offers potential advantages over traditional OMs.

Purpose of the Study:

• To assess the feasibility and performance of a robotic-guided 3D exoscope in microneurosurgery.
• To compare the 3D exoscope with the conventional OM.

Main Methods:

• 16 surgical procedures comparing 3D exoscope and OM.
• Surgeon satisfaction surveys (Likert scale) and NASA task load index (NASA-TLX) were administered.
• A predefined suturing task evaluated performance across different experience levels.

Main Results:

• The 3D exoscope demonstrated superior magnification and ergonomics but lower image quality.
• Surgeons reported higher satisfaction with OM for stereoscopic orientation.
• No significant differences in workload (NASA-TLX) or task completion time were observed between the two modalities.

Conclusions:

• The 3D exoscope provides adequate visualization and superior ergonomics for microneurosurgery.
• While experienced surgeons were faster with OM in a simulation, the 3D exoscope is a strong alternative.
• Ergonomic benefits may outweigh minor trade-offs in image quality for certain procedures.