Technical aspects and operative nuances using a high-definition 4K-3-dimensional exoscope for carotid endarterectomy surgery

Author(s):  
Jason A. Ellis ◽  
Omer Doron ◽  
Julia R. Schneider ◽  
Catherine M. Higbie ◽  
Kay O. Kulason ◽  
...  
Ophthalmology ◽  
2006 ◽  
Vol 113 (11) ◽  
pp. 2054-2065.e3 ◽  
Author(s):  
Vivek J. Srinivasan ◽  
Maciej Wojtkowski ◽  
Andre J. Witkin ◽  
Jay S. Duker ◽  
Tony H. Ko ◽  
...  

Author(s):  
Jeffry Kahn ◽  
Avram Bar-Cohen

Plasma Display Panels (PDPs) are a popular technology for large size television displays. Screen inefficiencies, which result in significant localized heat generation, necessitate the use of advanced thermal management materials to reduce both the peak temperatures and the spatial temperature variations across the screen. In the current study, infrared thermography was used to obtain thermal maps of a typical, 42", high-definition PDP screen for different illumination patterns and for several configurations of externally controlled heaters, simulating PDP heat generation. The results were used to validate a 3-dimensional numerical thermal model of the PDP which was then used to predict the beneficial effects of anisotropic graphite heat spreaders on the temperature distribution of the PDP. In addition, a color analyzer was used to determine the spatial and temporal variations in luminosity across the PDP when operated continuously for 1750 hours with different illumination patterns. The thermal model and experimental luminosity characteristics are used to evaluate the deleterious effects of temperature on PDP performance.


2017 ◽  
Vol 74 (4) ◽  
pp. 644-649 ◽  
Author(s):  
Riccardo Guanà ◽  
Luisa Ferrero ◽  
Salvatore Garofalo ◽  
Alessia Cerrina ◽  
Davide Cussa ◽  
...  

2019 ◽  
Vol 160 (2) ◽  
pp. 364-367 ◽  
Author(s):  
Sullivan Smith ◽  
Elliott D. Kozin ◽  
Vivek V. Kanumuri ◽  
Samuel R. Barber ◽  
Douglas Backous ◽  
...  

Extracorporeal video microscopes, or “exoscopes,” provide high-definition views of the operative field and are alternatives to the operating microscope or loupes for large-corridor surgical approaches. In this proof-of-concept study, we aim to determine the feasibility of 3-dimensional exoscopes as alternatives to operating microscopes in otology and neurotology, espeically in conjunction with endoscopes. Eleven consecutive cases were performed using 3-dimensional exoscopes in place of, or as adjuncts to, the operating microscope. The exoscope was the sole visualization tool in 7 cases, with 4 including the use of an endoscope or microscope. There were no perioperative complications. Potential subjective advantages include superior ergonomics, compact size, and an equal visual experience for surgeons and observers. Limitations include low lighting in small surgical corridors and pixilation at high magnification. Exoscopes are potentially viable alternatives to the microscope in otologic and neurotologic surgery.


2019 ◽  
Vol 19 (2) ◽  
pp. E188-E188
Author(s):  
Jonathan Oren ◽  
Kevin Kwan ◽  
Julia Schneider ◽  
Mitchell Levine ◽  
David Langer

Abstract This surgical video is the first to demonstrate a novel minimally invasive technique of utilization of surgically navigated foraminal discectomy using a 3-dimensional 4k high-definition exoscope (Sony Olympus). Typical approaches for foraminal disc herniations may involve violation of the facet resulting in subsequent destabilization requiring fusion.1 Although minimally invasive facet-sparing contralateral techniques have previously been described,2 there is continued limitations stemming from rudimentary localization with standard fluoroscopy and impaired visualization with the bulky traditional operative microscope.3 We demonstrate that high-quality real-time navigation is possible using standard Iso-C intraoperative fluoroscopy for 3-dimensional reconstructions, allowing for intraoperative routing. Navigation is particularly advantageous for adjustments in the trajectory of the tubular retractor and for confirmation of complete foraminal decompression. Visualization from the 4k high-definition exoscope also allows for an unparalleled view of the narrow operative corridor and allows for participation from the operative team. Informed consent was obtained from the patient for the surgery in its entirety.


2013 ◽  
Vol 10 (1) ◽  
pp. 116-120 ◽  
Author(s):  
Andrea Bolzoni Villaret ◽  
Paolo Battaglia ◽  
Manfred Tschabitscher ◽  
Davide Mattavelli ◽  
Mario Turri-Zanoni ◽  
...  

Abstract An endoscopic approach through the transnasal corridor is currently the treatment of choice in the management of benign sinonasal tumors, cerebrospinal fluid leaks, and pituitary lesions. Moreover, this approach can be considered a valid option in the management of selected sinonasal malignancies extending to the skull base, midline meningiomas, parasellar lesions such as craniopharyngioma and Rathke cleft cyst, and clival lesions such as chordoma and ecchordosis. Over the past decade, strict cooperation between otorhinolaryngologists and neurosurgeons and acquired surgical skills, together with high-definition cameras, dedicated instrumentation, and navigation systems, have made it possible to broaden the indications of endoscopic surgery. Despite these improvements, depth perception, as provided by the use of a microscope, was still lacking with this technology. The aim of the present project is to reveal new perspectives in the endoscopic perception of the sinonasal complex and skull base thanks to 3-dimensional endoscopes, which are well suited to access and explore the endonasal corridor. In the anatomic dissection herein, this innovative device came across with sophisticated and long-established fresh cadaver preparation provided by one of the most prestigious universities of Europe. The final product is a 3-dimensional journey starting from the nasal cavity, reaching the anterior, middle, and posterior cranial fossae, passing through the ethmoidal complex, paranasal sinuses, and skull base. Anatomic landmarks, critical areas, and tips and tricks to safely dissect delicate anatomic structures are addressed through audio comments, figures, and their captions.


2018 ◽  
Vol 16 (6) ◽  
pp. 717-725 ◽  
Author(s):  
Alexander A Khalessi ◽  
Ralph Rahme ◽  
Robert C Rennert ◽  
Pia Borgas ◽  
Jeffrey A Steinberg ◽  
...  

ABSTRACT BACKGROUND During its development and preclinical assessment, a novel, 3-dimensional (3D), high-definition (4K-HD) exoscope system was formerly shown to provide an immersive surgical experience, while maintaining a portable, low-profile design. OBJECTIVE To assess the clinical applicability of this 3D 4K-HD exoscope via first-in-man surgical use. METHODS The operative workflow, functionality, and visual haptics of the 3D 4K-HD exoscope were assessed in a variety of microneurosurgical cases at 2 US centers. RESULTS Nineteen microneurosurgical procedures in 18 patients were performed exclusively using the 3D 4K-HD exoscope. Pathologies treated included 4 aneurysms, 3 cavernous malformations (1 with intraoperative electrocorticography), 2 arteriovenous malformations, 1 foramen magnum meningioma, 1 convexity meningioma, 1 glioma, 1 occipital cyst, 1 chiari malformation, 1 carotid endarterectomy, 1 subdural hematoma, 1 anterior cervical discectomy and fusion, and 2 lumbar laminectomies. All patients experienced good surgical and clinical outcomes. Similar to preclinical assessments, the 3D 4K-HD exoscope provided an immersive 3D surgical experience for the primary surgeon, assistants, and trainees. The small exoscope frame, large depth of field, and hand/foot pedal controls improved exoscope mobility, decreased need to re-focus, and provided unobstructed operative corridors. Flexible positioning of the camera allows the surgeon's posture to be kept in a neutral position with uncompromised viewing angles. CONCLUSION The first-in-man clinical experience with the 3D 4K-HD exoscope confirms its excellent optics and ergonomics for the entire operative team, with high workflow adaptability for a variety of microneurosurgical cases. Expanded clinical use of the 3D 4K-HD exoscope is justified.


Neurosurgery ◽  
2014 ◽  
Vol 74 (4) ◽  
pp. 375-381 ◽  
Author(s):  
Hani J. Marcus ◽  
Archie Hughes-Hallett ◽  
Thomas P. Cundy ◽  
Aimee Di Marco ◽  
Philip Pratt ◽  
...  

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