Microsurgery without a microscope: laboratory evaluation of a three-dimensional on-screen microsurgery system

Area of Science:

• Microsurgical techniques
• Surgical ergonomics
• Medical device innovation

Background:

• Microvascular surgery demands precision and endurance, often leading to surgeon fatigue.
• Current microscope systems require sustained, fixed viewing, causing positioning issues and discomfort.
• Surgeon and assistant positioning challenges are significant in prolonged microsurgical operations.

Purpose of the Study:

• To evaluate a novel microscope system, the Three-dimensional On-screen Microsurgical System (TOMS), as an alternative to traditional eyepiece viewing.
• To assess the impact of TOMS on surgeon comfort, instructional capabilities, and technological performance in microsurgery.
• To determine if TOMS can mitigate the physical and mental fatigue associated with demanding microvascular procedures.

Main Methods:

• A laboratory-based comparative study contrasting TOMS with conventional microsurgical techniques.
• Standardized questionnaires were used to evaluate surgeon comfort, teaching ability, and system performance.
• Objective and subjective assessments of the surgical procedure and surgeon/assistant ergonomics were conducted.

Main Results:

• The Three-dimensional On-screen Microsurgical System (TOMS) showed potential in reducing physical demands on the surgeon.
• Surgeon and assistant comfort levels were potentially improved with the TOMS compared to traditional methods.
• Technological performance and instructional capabilities require further refinement for widespread adoption.

Conclusions:

• The TOMS offers a promising approach to alleviate physical strain and enhance comfort in prolonged microvascular surgery.
• Decoupling the surgeon's view from microscope eyepieces may revolutionize surgical ergonomics.
• Further technological advancements are necessary to optimize the TOMS for clinical application.