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The Microscopic Transcanal Approach in Stapes Surgery Revisited

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Binocular microscopes versus exoscopes: Experiences and performance in simulated otologic surgery.

Riley Larkin¹, Jake Langlie¹, Luis Pablo Roldan^2,3

¹University of Miami Miller School of Medicine Miami Florida USA.

Laryngoscope Investigative Otolaryngology

|October 30, 2023

Summary

Exoscopes show promise in otologic surgery, but operative microscopes (OM) were faster for most tasks in simulated surgeries. User experience varied by surgical experience level, with residents preferring OM and students favoring exoscopes.

Keywords:

exoscope medical education operative microscope otology surgical simulation

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Area of Science:

Otolaryngology
Surgical Simulation
Medical Device Technology

Background:

Exoscopes offer potential ergonomic and design advantages over traditional operative microscopes (OM) in otology.
Objective assessment of exoscopes in otologic surgery is limited, necessitating further research.

Purpose of the Study:

To evaluate the task-based efficiency of exoscopes compared to OM in simulated otologic surgical models.
To analyze differences in performance metrics and user experience between the two visualization systems.

Main Methods:

A prospective, cross-over study design compared exoscopes and OM in otolaryngology residents and medical students.
Participants performed standardized tasks on 3D-printed ear models, with data collected on completion time, errors, mental effort, and user experience.
Subgroup analysis was conducted based on participants' level of surgical experience.

Main Results:

Participants completed most tasks faster with the OM, with no significant difference in error rates overall.
Residents performed tasks faster with the OM, while students showed a slight speed advantage with the OM on one task.
Students committed more errors with the exoscope on one task; perceived difficulty was similar for both systems.
Exit surveys revealed residents preferred the OM, whereas students favored the exoscope.

Conclusions:

Exoscopes are capable of successful performance in simulated otologic tasks.
Task efficiency and user experience with exoscopes versus OM are influenced by the level of surgical experience.