High-Definition 3-D Exoscope for Micro-Laryngeal Surgery: A Preliminary Clinical Experience in 41 Patients.

OBJECTIVE: The aim of this prospective clinical study is to evaluate the feasibility of the micro-laryngeal surgery (MLS) using a 3D operating exoscope (OE) in substitution to a conventional operating microscope (OM). METHODS: A total of 41 consecutive patients were included (male: 26; median age: 55.0 years; IQR: 46.0-68.0). After each procedure, the surgeon and the scrub nurse were asked to fill out a tailored questionnaire on a 3-point Likert scale (1-not acceptable, 2-acceptable, 3-good) including 12 items. RESULTS: The majority of the procedures were therapeutic (n = 31, 75.6%), while the remaining were diagnostic (n = 10, 24.4%). All surgeries were successfully completed without the support of the OM, and no complications or unwanted delays were detected. The majority of the individual items were judged "good" either by surgeons (n = 399, 81.1%) and scrub nurses (n = 287, 87.5%). The natural posture during the procedure, and the ease of use the joystick and focusing were the best-rated items by the surgeons. CONCLUSIONS: This study demonstrates the feasibility of MLS using the OE. Further comparative clinical studies are needed to clarify its real value in substitution to a conventional operating microscope and to better define advantages and disadvantages.

Preliminary clinical experience with the 4 K3-dimensional microvideoscope (VITOM 3D) system for free flap head and neck reconstruction.

BACKGROUND: To demonstrate the use of a 4 K 3-dimensional microvideoscope (VITOM 3D) system for free flap head and neck reconstruction. METHODS: Clinical human study of free flap harvesting and microvascular anastomosis in patients undergoing reconstruction after ablative surgery for head and neck carcinoma. The video shows the harvesting of a chimeric myofascial/fascio-cutaneous anterolateral thigh free flap and microvascular anastomosis using different techniques. RESULTS: The VITOM 3D exoscope system provided sufficient access, reach, and visualization to perform successfully free flap harvesting and microvascular anastomosis. Using the 3D glasses, both surgeons and nurses can have the same visualization throughout the entire procedure. We performed 10 arterial and venous anastomosis without significant complications. CONCLUSIONS: This study demonstrates the technical feasibility of free flap harvesting and microvascular anastomosis using the 4 K3-Dimensional Microvideoscope (VITOM 3D) System.