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Three-Dimensional Video Microscopy: Potential for Improved Ergonomics without Increased Operative Time?

Yasmina Samaha¹, Edward Ray¹

¹Division of Plastic and Reconstructive Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.

Archives of Plastic Surgery

|February 9, 2023

Summary

Three-dimensional video exoscopes offer an ergonomic alternative for microsurgery, reducing surgeon discomfort during free flap procedures. Operating times remained comparable to traditional microscopes, indicating promising ergonomic benefits.

Keywords:

ergonomics free tissue flaps microscopes microsurgery operating room

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Area of Science:

Microsurgery
Surgical Technology
Plastic Surgery

Background:

Three-dimensional (3D) video exoscopes are advanced optical devices utilized in surgical procedures.
While beneficial for ergonomics in microsurgery, exoscopes have sometimes been associated with increased operating times.
Their application in free flap procedures, particularly in comparison to traditional surgical microscopes, requires further investigation.

Purpose of the Study:

To compare the ergonomic benefits and operative efficiency of 3D video exoscopes versus traditional binocular microscopes in free flap procedures.
To evaluate surgeon comfort and operating times using a 3D exoscope in microvascular reconstruction.

Main Methods:

A single surgeon performed free flap procedures between 2020 and 2021, utilizing both a conventional binocular microscope (10 cases) and a 3D video exoscope (8 cases).
Surgeon-reported neck discomfort and total operating times were recorded and compared between the two methods.
The surgeon had minimal prior experience with the 3D exoscope before this series.

Main Results:

The surgeon reported reduced neck discomfort when using the 3D exoscope compared to the binocular microscope.
Average total operating time was similar for both the exoscope and microscope groups (13.7 hours vs. 13.4 hours, p=0.34).

Conclusions:

The 3D video exoscope presents a promising ergonomic alternative for microvascular reconstruction, including free flap procedures.
Its use did not lead to an increase in overall surgical time in this early experience.
Further research is warranted to compare free flap ischemia times between exoscope and microscope use.