Exoscopes in Neurosurgery: A Bibliometric and Visualization Analysis

Exoscopes, introduced as an alternative to operative microscopes in neurosurgery, aim to enhance intraoperative visualization, ergonomics, cost-effectiveness, and patient outcomes. This study employs bibliometric analysis to delineate topic trends and fields within neurosurgery utilizing exoscopes. Articles and reviews from January 1, 2002 to December 31, 2023, were manually retrieved from Scopus, based on predefined criteria encompassing publications related to exoscopes in neurosurgery. All publication records were imported and analyzed using Microsoft Excel and VOSviewer. A total of 186 articles were included for final analysis. While work on exoscopes was limited until 2015, there was an upsurge in publication output from 2018 to 2022. The United States led in the number of articles (72/186, 38.7%) and in total citations (1259). Brazil ranked first in average citation index (26.00). The Hospital of the University of Pennsylvania, United States, published the most articles (5), while Cedars-Sinai Medical Center USA accrued the highest number of citations (181). A.J. Schupper (4) and Constantinos Hadjipanayis (7) were the authors with the most publications as the first author and the last author, respectively. World Neurosurgery was the most prolific journal with 41 publications. Recent keywords centered around themes such as "ergonomics" (47 times) and "three-dimensional imaging" (44 times). Most collaboration occurred between developed countries such as the United States, Germany, Finland, and Austria. Most articles (87) focused on brain, with 25 articles focusing on spine. Our findings offer valuable insights to identify potential research frontiers within different fields of neurosurgery in the coming years.