Lessons Learned Using a High-Definition 3-Dimensional Exoscope for Spinal Surgery

2018 ◽  
Vol 16 (5) ◽  
pp. 619-625 ◽  
Author(s):  
Kevin Kwan ◽  
Julia R Schneider ◽  
Victor Du ◽  
Lukas Falting ◽  
John A Boockvar ◽  
...  
Keyword(s):  
Spinal Surgery ◽  
Clinical Effectiveness ◽  
Lessons Learned ◽  
Depth Of Field ◽  
Surgical Approaches ◽  
Quantitative Methodology ◽  
High Definition ◽  
3D Vision ◽  
Team Members ◽  
3 Dimensional

Abstract BACKGROUND The operative microscope has significantly advanced modern neurosurgical spine surgery but continues to be limited by high costs, suboptimal optics, poor ergonomics, and difficulties with maneuverability. We believe the novel 4K high-definition (4K-HD) 3-dimensional (3D) exoscope (EX), may improve the surgical corridor through advancements in illumination, ergonomics, magnification, and depth of field and has the potential to be utilized in neurosurgical education and training. OBJECTIVE To evaluate the surgical potential of a novel 3D EX system in spinal surgery. METHODS Retrospective analysis over 6 mo of all patients who have undergone spinal surgery at Northwell Health using the 3D EX. Nuances of surgical theater positioning, advantages/disadvantages of the EX and clinical sequelae of the patients were analyzed. RESULTS All 10 patients who underwent spinal surgery utilizing the EX experienced excellent surgical and clinical outcomes without complications. The low-profile EX allowed for excellent operative corridors and instrument maneuverability. The large monitor also resulted in an immersive surgical experience, and gave team members the same 3D vision as the operator. CONCLUSION This study demonstrates the feasibility of utilizing the 3D 4K-HD EX system and highlights potential technical assets of this novel technology in regard to optics, ergonomics, and maneuverability. Further clinical research is needed to examine the clinical effectiveness of the EX system for different surgical approaches through quantitative methodology.

Initial Experience with 3-Dimensional Exoscope-Assisted Transmastoid and Lateral Skull Base Surgery

2019 ◽  
Vol 160 (2) ◽  
pp. 364-367 ◽  
Author(s):  
Sullivan Smith ◽  
Elliott D. Kozin ◽  
Vivek V. Kanumuri ◽  
Samuel R. Barber ◽  
Douglas Backous ◽  
...  
Keyword(s):  
Visual Experience ◽  
Skull Base Surgery ◽  
Perioperative Complications ◽  
Surgical Approaches ◽  
Operating Microscope ◽  
Proof Of Concept ◽  
High Definition ◽  
3 Dimensional ◽  
Lateral Skull Base ◽  
Compact Size

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.

First-in-Man Clinical Experience Using a High-Definition 3-Dimensional Exoscope System for Microneurosurgery

2018 ◽  
Vol 16 (6) ◽  
pp. 717-725 ◽  
Author(s):  
Alexander A Khalessi ◽  
Ralph Rahme ◽  
Robert C Rennert ◽  
Pia Borgas ◽  
Jeffrey A Steinberg ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Arteriovenous Malformations ◽  
Foramen Magnum ◽  
Depth Of Field ◽  
Neutral Position ◽  
Surgical Experience ◽  
High Definition ◽  
Cavernous Malformations ◽  
3 Dimensional ◽  
Low Profile

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.

Initial Experience Using a High-Definition 3-Dimensional Exoscope System for Microneurosurgery

2017 ◽  
Vol 14 (4) ◽  
pp. 395-401 ◽  
Author(s):  
Jayson Sack ◽  
Jeffrey A Steinberg ◽  
Robert C Rennert ◽  
Dustin Hatefi ◽  
Jeffrey S Pannell ◽  
...  
Keyword(s):  
Neutral Position ◽  
The Novel ◽  
Operating Microscope ◽  
High Definition ◽  
Team Members ◽  
3 Dimensional ◽  
Primary Operator ◽  
Low Profile ◽  
Standard Operating ◽  
Operative Microscope

Abstract BACKGROUND The operative microscope and endoscope have significantly advanced modern neurosurgery. These devices are nonetheless limited by high costs and suboptimal optics, ergonomics, and maneuverability. A recently developed extracorporeal telescope (“exoscope”) operative system combines characteristics from both the operative microscope and endoscope and provides an affordable, portable, high-definition operative experience. Widespread use of exoscopes in neurosurgery has previously been limited by a lack of stereopsis with 2-dimensional(2-D) monitors. OBJECTIVE To assess the surgical potential of a novel, 3-D, high-definition (4K-HD) exoscope system. METHODS Assess dissection time and visualization of critical structures in a series of human cadaveric cranial neurosurgical approaches with the 3-D 4K-HD exoscope as compared to a standard operating microscope. RESULTS Dissection times and visualization of critical structures was comparable with the 3-D 4K-HD exoscope and a standard operating microscope. The low-profile exoscope nonetheless allowed for larger operative corridors, enhanced instrument maneuverability, and less obstruction in passing instrumentation. The large monitor also resulted in an immersive surgical experience, and gave multiple team members the same high-quality view as the primary operator. Finally, the exoscope possessed a more ergonomically favorable setup as compared to the traditional microscope, allowing the surgeon to be in a neutral position despite the operative angle. CONCLUSION The novel 3-D 4K-HD exoscope system possesses favorable optics, ergonomics, and maneuverability as compared to the traditional operating microscope, with the exoscope's shared surgical view possessing obvious educational and workflow advantages. Further clinical trials are justified to validate this initial cadaveric experience.

Comparison of clinical and oncologic effectiveness between flexible 3-dimensional and bidimensional video-thoracoscopic surgery for lung cancer

2020 ◽  
pp. 030089162092590
Author(s):  
Alessandro Pardolesi ◽  
Luigi Rolli ◽  
Paolo Scanagatta ◽  
Leonardo Duranti ◽  
Luca Tavecchio ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Three Dimensional ◽  
Length Of Hospital Stay ◽  
Surgical Approaches ◽  
3D Vision ◽  
3 Dimensional ◽  
Retrospective Comparative Study ◽  
Uncontrolled Bleeding

Background: Three-dimensional (3D) vision systems are available for video-assisted thoracic surgery (VATS). It is unclear whether 3D-VATS is superior to bidimensional (2D) VATS systems. Methods: We analyzed patients who received 3D-VATS ( n = 171) or 2D-VATS ( n = 228) lobectomy in a single institutional retrospective comparative study of 399 patients with resectable lung cancer conducted from June 2012 to December 2017. The operative and perioperative data were compared between the 2 groups. Results: Operative time, length of hospital stay, number of dissected lymph nodes, and rate of postoperative complications were similar in both groups. In the 3D group, there was no conversion to thoracotomy for intraoperative major vascular injuries, while conversion to an open procedure for uncontrolled bleeding was recorded in 4 (1.7%) patients in the 2D group. Reoperation for hemostasis and/or aerostasis occurred in 6 (2.6%) patients of the 2D group ( p = 0.04). Conclusion: Nonrandomized comparison of different surgical approaches is challenging. In our experience, 3D-VATS was safe and effective and offered excellent operative perception and sensitivity, enabling safer dissection of hilar structures. The 3D-VATS system helped skilled surgeons beyond the boundaries of more oncologically aggressive surgery.

Correlative transmission and high-resolution scanning electron microscopic studies on pituitary cells

1990 ◽  
Vol 48 (3) ◽  
pp. 20-21
Author(s):  
S. Tai
Keyword(s):  
Cell Types ◽  
Depth Of Field ◽  
Secretory Cells ◽  
Specific Cell ◽  
Pituitary Cells ◽  
Electron Microscopic ◽  
3 Dimensional ◽  
Microscopic Studies ◽  
Structure And Activity ◽  
Intracellular Structure

Extensive cytological and histological research, correlated with physiological experimental analysis, have been done on the anterior pituitaries of many different vertebrates which have provided the knowledge to create the concept that specific cell types synthesize, store and release their specific hormones. These hormones are stored in or associated with granules. Nevertheless, there are still many doubts - that need further studies, specially on the ultrastructure and physiology of these endocrine cells during the process of synthesis, transport and secretion, whereas some new methods may provide the information about the intracellular structure and activity in detail.In the present work, ultrastructural study of the hormone-secretory cells of chicken pituitaries have been done by using TEM as well as HR-SEM, to correlate the informations obtained from 2-dimensional TEM micrography with the 3-dimensional SEM topographic images, which have a continous surface with larger depth of field that - offers the adventage to interpretate some intracellular structures which were not possible to see using TEM.

scholarly journals H3ABioNet genomic medicine and microbiome data portals hackathon proceedings

Database ◽  
2021 ◽  
Vol 2021 ◽  
Author(s):  
Faisal M Fadlelmola ◽  
Kais Ghedira ◽  
Yosr Hamdi ◽  
Mariem Hanachi ◽  
Fouzia Radouani ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Genomic Medicine ◽  
Lessons Learned ◽  
Team Work ◽  
Significant Progress ◽  
Team Members ◽  
Pan African ◽  
Scientific Expertise ◽  
Microbiome Data ◽  
Made In

Abstract African genomic medicine and microbiome datasets are usually not well characterized in terms of their origin, making it difficult to find and extract data for specific African ethnic groups or even countries. The Pan-African H3Africa Bioinformatics Network (H3ABioNet) recognized the need for developing data portals for African genomic medicine and African microbiomes to address this and ran a hackathon to initiate their development. The two portals were designed and significant progress was made in their development during the hackathon. All the participants worked in a very synergistic and collaborative atmosphere in order to achieve the hackathon's goals. The participants were divided into content and technical teams and worked over a period of 6 days. In response to one of the survey questions of what the participants liked the most during the hackathon, 55% of the hackathon participants highlighted the familial and friendly atmosphere, the team work and the diversity of team members and their expertise. This paper describes the preparations for the portals hackathon and the interaction between the participants and reflects upon the lessons learned about its impact on successfully developing the two data portals as well as building scientific expertise of younger African researchers. Database URL: The code for developing the two portals was made publicly available in GitHub repositories: [https://github.com/codemeleon/Database; https://github.com/codemeleon/AfricanMicrobiomePortal].

scholarly journals The COVID Army: Experiences from the Deployment of Non-Hospitalist Physician Volunteers during the 2020 COVID Pandemic

2021 ◽  
pp. 1-15
Author(s):  
Kevin Hauck ◽  
Katherine Hochman ◽  
Mark Pochapin ◽  
Sondra Zabar ◽  
Jeffrey A Wilhite ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
Medical Center ◽  
The United States ◽  
Lessons Learned ◽  
Front Line ◽  
Clinical Leadership ◽  
Team Members ◽  
Medical Centers ◽  
Hospitalist Physician

Abstract Objective New York City was the epicenter of the outbreak of the 2020 COVID-19 pandemic in the United States. As a large, quaternary care medical center, NYU Langone Medical Center was one of many New York medical centers that experienced an unprecedented influx of patients during this time. Clinical leadership effectively identified, oriented, and rapidly deployed a “COVID Army”, consisting of non-hospitalist physicians, to meet the needs of this patient influx. We share feedback from our providers on our processes and offer specific recommendations for systems experiencing a similar influx in the current and future pandemics. Methods In order to assess the experiences and perceived readiness of these physicians (n=183), we distributed a 32-item survey between March and June of 2020. Thematic analyses and response rates were examined in order to develop results. Results Responses highlighted varying experiences and attitudes of our front-line physicians during an emerging pandemic. Thematic analyses revealed a series of lessons learned, including the need to: (1) provide orientations, (2) clarify roles/ workflow, (3) balance team workload, (4) keep teams updated on evolving policies, (5) make team members feel valued, and (6) ensure they have necessary tools available. Conclusions Lessons from our deployment and assessment are scalable at other institutions.

scholarly journals Responding to unforeseen disasters in a large health system

2020 ◽  
Author(s):  
Ryan J Hannan ◽  
Margaret K Lundholm ◽  
Dennis Brierton ◽  
Noelle R M Chapman
Keyword(s):  
Supply Chain ◽  
Health System ◽  
Disaster Response ◽  
Well Being ◽  
Lessons Learned ◽  
Strategic Decision ◽  
Pharmacy Services ◽  
Efficient System ◽  
Team Members

Abstract Purpose To describe how health systems may respond to sudden changes in operations by leveraging existing resources and to share one organization’s experience responding to the coronavirus disease (COVID-19) pandemic. Summary In a health system based in Illinois and Wisconsin, pharmacy services are provided by a single, integrated department responsible for all aspects of pharmaceutical care within the organization. Hospital, retail, ambulatory care, and population health services are all managed under one leadership team. All pertinent ancillary services are also managed within the department, including informatics, supply chain, and drug policy. During the COVID-19 pandemic, the pharmacy services leadership has successfully managed volume and capacity challenges by redirecting resources to where they are needed. A disaster response framework based on Federal Emergency Management Agency guidance was put in place, and change management principles were used to rapidly operationalize change. Components of the nimble response have included quickly increasing capacity, thoughtful and timely communication to all team members, strategic decision making with available data, creating an agile pool of labor, and maintaining an efficient system supply chain. Well-being and resilience are emphasized alongside reflection on lessons learned. Some changes made in the urgent response to the pandemic are being considered for long-term implementation. Conclusion Organizations have the potential to respond to almost any situation if they are integrated and teams work together to build flexibility. The keys to success are thoughtful maximization of existing resources and strong communication.

scholarly journals Using a 4K three-dimensional exoscope system (Vitom 3D) for mastoid surgery during the coronavirus disease 2019 pandemic

2021 ◽  
pp. 1-3
Author(s):  
M Ally ◽  
P Kullar ◽  
G Mochloulis ◽  
A Vijendren
Keyword(s):  
Residual Disease ◽  
Elective Surgery ◽  
Three Dimensional ◽  
Depth Of Field ◽  
High Definition ◽  
Microscopic Surgery ◽  
Lateral Skull Base ◽  
Mastoid Surgery ◽  
And Training

Abstract Objective Microscopic surgery is currently considered the ‘gold standard’ for middle-ear, mastoid and lateral skull base surgery. The coronavirus disease 2019 pandemic has made microscopic surgery more challenging to perform. This work aimed to demonstrate the feasibility of the Vitom 3D system, which integrates a high-definition (4K) view and three-dimensional technology for ear surgery, within the context of the pandemic. Method Combined approach tympanoplasty and ossiculoplasty were performed for cholesteatoma using the Vitom 3D system exclusively. Results Surgery was performed successfully. The patient made a good recovery, with no evidence of residual disease at follow up. The compact system has excellent depth of field, magnification and colour. It enables ergonomic work, improved work flow, and is ideal for teaching and training. Conclusion The Vitom 3D system is considered a revolutionary alternative to microscope-assisted surgery, particularly in light of coronavirus disease 2019. It allows delivery of safe otological surgery, which may aid in continuing elective surgery.

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