VITOM 3D exoscopic system compared to microsurgical technique in spinal surgery

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OBJECTIVE

To compare the effectiveness of VITOM 3D exoscopy and microsurgical techniques in spinal surgery.

MATERIAL AND METHODS

A prospective study included 80 patients (54 men and 26 women). Two groups were distinguished: group 1 (ES, n=40) — VITOM 3D exoscopy, group 2 (SM, n=40) — Pentero 900 surgical microscope. We analyzed surgery time, postoperative rehabilitation, hospital-stay and complications. ES and microsurgical technique were compared using the questionnaire by Takahashi S. and rapid upper limb assessment (RULA).

RESULTS

Conventional microsurgical technique was characterized by less surgery time (p<0.05) and morbidity (p=0.02). Postoperative rehabilitation and hospital-stay were similar (p=0.26 and p=0.39, respectively). Image quality in ES was comparable to microsurgical technique in shallow accesses and manipulations perpendicular to skin incision. Availability of neurosurgical instruments at different depths of the wound channel was comparable in both groups. The limitation of ES was length of skin incision, depth of the wound and its visualization at certain angle. These features required expansion of surgical approach or conversion of intervention. In general, surgeons rated intraoperative posture comfort as comparable in both groups that was consistent with the RULA scale.

CONCLUSION

VITOM 3D exoscopy is an alternative to traditional microscopy and more ergonomically beneficial in spinal surgery in case of manipulations perpendicular to skin incision and shallow wide accesses. There are several important limitations of this device including difficult manipulations in narrow deep wounds and visualization under certain angle.

Keywords:

degenerative spine disease

3D visualization

video telescopic operating monitor

exoscope

operating microscope

microsurgical equipment

Authors:

Byvaltsev V.A.

Irkutsk State Medical University;
Russian Railways-Medicine Clinical Hospital;
Irkutsk State Medical Academy of Postgraduate Education

ORCID: 0000-0003-4349-7101

Kalinin A.A.

Irkutsk State Medical University;
Russian Railways-Medicine Clinical Hospital

ORCID: 0000-0002-6059-4344

Received:

23.05.2023

Accepted:

13.07.2023

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