3D4K exoscope in epilepsy surgery: a seminal experience

Area of Science:

• Neurosurgery
• Epileptology
• Surgical Technology

Background:

• The study reports the progressive integration of the exoscope (EX) in epilepsy surgery, from superficial lesionectomies to antero-mesial temporal lobectomies (AMTL).
• This research evaluates the exoscope's utility in a clinical epilepsy surgery setting.

Purpose of the Study:

• To assess the safety and efficacy of the exoscope (EX) in various epilepsy surgical procedures.
• To compare outcomes of exoscope-assisted surgery with traditional operative microscopy (OM).

Main Methods:

• A cohort of ten consecutive patients undergoing exoscope surgery was compared to a similar group having operative microscopic surgery (OM).
• All surgeries utilized either the exoscope or operative microscope exclusively.
• Patient outcomes were assessed with a minimum follow-up of six months.

Main Results:

• Both exoscope and operative microscopy groups reported one transient neurological complication in surgeries involving eloquent regions.
• A higher proportion of patients achieved Engel class Ia seizure control with the exoscope (90%) compared to operative microscopy (70%).
• Mean surgical duration was longer for exoscope procedures (265.5 min) versus operative microscopy (237.9 min), and particularly for AMTL cases (308.3 min vs. 253.3 min).

Conclusions:

• The ORBEYE exoscope demonstrates safety and effectiveness across diverse epilepsy surgeries.
• Transitioning to exoscope use is efficient, though more time-consuming for complex AMTL.
• Exoscope use enhances surgical ergonomics and operative team collaboration, warranting further investigation in larger studies.