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Updated: Jun 8, 2026

Multimodal Volumetric Retinal Imaging by Oblique Scanning Laser Ophthalmoscopy oSLO and Optical Coherence Tomography OCT

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Exoscopic Visualization for Transorbital Surgery: Preliminary Anatomical and Clinical Validation Study.

Francesco Corrivetti^1,2, Matteo de Notaris^1,2, Sergio Corvino^1,2,3

¹Laboratory of Neuroanatomy, European Biomedical Research Institute of Salerno (EBRIS) Foundation, 84125 Salerno, Italy.

Journal of Clinical Medicine

|November 27, 2025

Summary

The exoscope enhances visualization in transorbital surgery, particularly for the skin and orbital phases. While beneficial, the endoscope remains crucial for intracranial procedures, with combined approaches showing improved efficiency.

Keywords:

cadaveric dissection exoscope neuroendoscopy transorbital

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Area of Science:

Neurosurgery
Surgical Visualization Technology

Background:

The endoscopic transorbital approach (ETOA) is a minimally invasive technique for lateral skull base access.
Recent advancements explore exoscopic visualization as an alternative to traditional endoscopic methods in ETOA.

Purpose of the Study:

To evaluate the effectiveness of exoscopic visualization compared to endoscopic visualization in ETOA.
To assess the impact of exoscopic use across different surgical phases: skin, orbital, and intracranial.

Main Methods:

Eight cadaveric specimens were dissected using four different visualization strategies: pure endoscopic ETOA, combined exoscopic/endoscopic ETOA (partial or extensive exoscope use), and pure exoscopic ETOA.
Surgeons rated operative comfort, maneuverability, and image quality.
CT scans were used for volumetric analysis of the surgical cavity; operative times were recorded.

Main Results:

Exoscopic visualization significantly improved working space and access during the skin and orbital phases.
Endoscopic visualization offered superior clarity and magnification for deep orbital structures.
Combined approaches resulted in shorter operative times and higher surgeon satisfaction ratings.

Conclusions:

The exoscope is a valuable tool for transorbital surgery, especially for superficial dissection.
Endoscopic visualization remains indispensable for the intracranial phase of ETOA.
The orbital phase can be effectively managed by either technique, with combined approaches offering practical advantages.