Archives of Plastic Surgery

  • 제50권1호
  • /
  • Pages.125-129
  • /
  • 2023
  • /
  • 2234-6163(pISSN)
  • /
  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
권호 표지
DOI QR코드

DOI QR Code

Three-Dimensional Video Microscopy: Potential for Improved Ergonomics without Increased Operative Time?

  • Yasmina Samaha (Division of Plastic and Reconstructive Surgery, Department of Surgery, Cedars-Sinai Medical Center) ;
  • Edward Ray (Division of Plastic and Reconstructive Surgery, Department of Surgery, Cedars-Sinai Medical Center)
  • 투고 : 2022.04.17
  • 심사 : 2022.09.01
  • 발행 : 2023.01.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Three-dimensional (3D) video exoscopes are high-magnification stereo cameras that project onto monitors mounted in the operating room, viewable from different angles. Outside of plastic surgery, exoscopes have been shown to successfully improve the ergonomics of microsurgery, though sometimes with prolonged operating times. We compare a single surgeon's early experience performing free flap procedures from 2020 to 2021 using either a binocular microscope or a 3D video exoscope. Ten procedures were performed with the standard operating microscope and 8 procedures with the 3D exoscope. The microsurgeon, having minimal prior experience using an exoscope, reported less neck discomfort following the free flap procedures performed with the exoscope compared with the binocular surgical microscope. Total average operating time was comparable between the standard surgical microscope and the 3D exoscope (13.7 vs. 13.4 hours, p = 0.34). Our early experience using a 3D exoscope in place of a standard optical microscope demonstrated that the exoscope shows promise, offering an ergonomic alternative during microvascular reconstruction without increasing overall operating times. Future studies will compare free flap ischemia time between cases performed using the exoscope and the conventional binocular microscope. Medical Subject Headings authorized following words: free tissue flaps; operating rooms; ergonomics; microsurgery.

키워드

과제정보

The authors would like to acknowledge Dr. Randy Sherman for his financial support of the Cedars-Sinai Medical Center Plastic and Reconstructive Surgery clinical research program.

참고문헌

  1. Ahmad FI, Mericli AF, DeFazio MV, et al. Application of the ORBEYE three-dimensional exoscope for microsurgical procedures. Microsurgery 2020;40(04):468-472 https://doi.org/10.1002/micr.30547
  2. Epstein S, Sparer EH, Tran BN, et al. Prevalence of work-related musculoskeletal disorders among surgeons and interventionalists: a systematic review and meta-analysis. JAMA Surg 2018;153 (02):e174947. Doi: 10.1001/jamasurg.2017.4947
  3. Ohlsson K, Attewell RG, Palsson B, et al. Repetitive industrial work and neck and upper limb disorders in females. Am J Ind Med 1995;27(05):731-747 https://doi.org/10.1002/ajim.4700270508
  4. Godwin Y, Macdonald CR, Kaur S, Zhelin L, Baber C. The impact of cervical musculoskeletal disorders on UK consultant plastic surgeons: can we reduce morbidity with applied ergonomics? Ann Plast Surg 2017;78(06):602-610 https://doi.org/10.1097/SAP.0000000000001073
  5. Capone AC, Parikh PM, Gatti ME, Davidson BJ, Davison SP. Occupational injury in plastic surgeons. Plast Reconstr Surg 2010;125(05):1555-1561 https://doi.org/10.1097/PRS.0b013e3181d62a94
  6. Khansa I, Khansa L, Westvik TS, Ahmad J, Lista F, Janis JE. Work-related musculoskeletal injuries in plastic surgeons in the United States, Canada, and Norway. Plast Reconstr Surg 2018;141(01):165e-175e https://doi.org/10.1097/PRS.0000000000003961
  7. Oertel JM, Burkhardt BW. Vitom-3D for exoscopic neurosurgery: initial experience in cranial and spinal procedures. World Neurosurg 2017;105:153-162 https://doi.org/10.1016/j.wneu.2017.05.109
  8. Krishnan KG, Scholler K, Uhl E. Application of a compact highdefinition exoscope for illumination and magnification in highprecision surgical procedures. World Neurosurg 2017;97:652-660 https://doi.org/10.1016/j.wneu.2016.09.037
  9. Mamelak AN, Danielpour M, Black KL, Hagike M, Berci G. A highdefinition exoscope system for neurosurgery and other microsurgical disciplines: preliminary report. Surg Innov 2008;15(01):38-46 https://doi.org/10.1177/1553350608315954
  10. Sack J, Steinberg JA, Rennert RC, et al. Initial experience using a high-definition 3-dimensional exoscope system for microneurosurgery. Oper Neurosurg (Hagerstown) 2018;14(04):395-401 https://doi.org/10.1093/ons/opx145
  11. Takahashi S, Toda M, Nishimoto M, et al. Pros and cons of using ORBEYE™ for microneurosurgery. Clin Neurol Neurosurg 2018;174:57-62 https://doi.org/10.1016/j.clineuro.2018.09.010
  12. Yu D, Green C, Kasten SJ, Sackllah ME, Armstrong TJ. Effect of alternative video displays on postures, perceived effort, and performance during microsurgery skill tasks. Appl Ergon 2016;53(Pt A):281-289 https://doi.org/10.1016/j.apergo.2015.10.016
  13. Rossini Z, Cardia A, Milani D, Lasio GB, Fornari M, D'Angelo V. VITOM 3D: preliminary experience in cranial surgery. World Neurosurg 2017;107:663-668 https://doi.org/10.1016/j.wneu.2017.08.083
  14. Kwan K, Schneider JR, Du V, et al. Lessons Learned Using a High-Definition 3-Dimensional Exoscope for Spinal Surgery. Vol 16.; 2019 Doi: 10.1093/ons/opy196
  15. Mamelak AN, Nobuto T, Berci G. Initial clinical experience with a high-definition exoscope system for microneurosurgery. Neurosurgery 2010;67(02):476-483 https://doi.org/10.1227/01.NEU.0000372204.85227.BF
  16. Fiani B, Jarrah R, Griepp DW, Adukuzhiyil J. The role of 3D exoscope systems in neurosurgery: an optical innovation. Cureus 2021;13(06):e15878. Doi: 10.7759/cureus.15878
  17. Muhammad S, Lehecka M, Niemela M Preliminary experience with a digital robotic exoscope in cranial and spinal surgery: a review of the Synaptive Modus V system. Acta Neurochir (Wien) 2019;161(10):2175-2180 https://doi.org/10.1007/s00701-019-03953-x
  18. Kokosis G, Dellon LA, Lidsky ME, Hollenbeck ST, Lee BT, Coon D. Prevalence of musculoskeletal symptoms and ergonomics among plastic surgery residents: results of a national survey and analysis of contributing factors. Ann Plast Surg 2020;85(03):310-315 https://doi.org/10.1097/SAP.0000000000002147
  19. Wanibuchi M, Komatsu K, Akiyama Y, Mikami T, Mikuni N. Effectiveness of the 3D monitor system for medical education during neurosurgical operation. World Neurosurg 2018;109:e105-e109 https://doi.org/10.1016/j.wneu.2017.09.113
  20. Piatkowski AA, Keuter XHA, Schols RM, van der Hulst RRWJ. Potential of performing a microvascular free flap reconstruction using solely a 3D exoscope instead of a conventional microscope. J Plast Reconstr Aesthet Surg 2018;71(11):1664-1678 https://doi.org/10.1016/j.bjps.2018.07.032