Evaluating the exoscope as an alternative to the operating microscope in plastic surgery

Area of Science:

• Microsurgery and surgical technology advancements.

Background:

• Microsurgery is vital for procedures like vessel anastomosis, flap harvesting, lymphedema treatment, and nerve reconstruction.
• The operating microscope, invented in the 1920s, has been the standard tool for microsurgery.
• Exoscopes represent a recent technological evolution in surgical visualization.

Purpose of the Study:

• To evaluate the efficacy and safety of exoscopes compared to traditional operating microscopes in microsurgery.
• To synthesize findings from studies directly comparing exoscope and microscope use in plastic and microvascular surgery.

Main Methods:

• A systematic literature search was performed across PubMed, Scopus, Web of Science, and Embase.
• Search terms included "Microscope AND exoscope AND plastic surgery" and "Microscope AND exoscope AND microvascular surgery."
• Full-text articles comparing exoscope and microscope use were included.

Main Results:

• Twelve studies were included from 69 initially identified.
• Exoscopes were consistently reported as a valid, non-inferior alternative to operating microscopes.
• Superior ergonomics were a common finding, though initial image quality concerns were noted, potentially resolved in newer models.

Conclusions:

• Exoscopes are a safe and viable alternative to operating microscopes in plastic surgery.
• Contemporary exoscope models address earlier limitations in image quality and zoom capabilities.
• The adoption of exoscopes may enhance surgical practice through improved ergonomics and comparable outcomes.