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논문 기본 정보

자료유형
학술저널
저자정보
Mohd Hisam Muhamad Ariffin (UKM Medical Centre) Kamalnizat Ibrahim (UKM Medical Centre) Azmi Baharudin (UKM Medical Centre) Azmi Mohd Tamil (UKM Medical Centre)
저널정보
대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.14 No.1
발행연도
2020.1
수록면
59 - 65 (7page)

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Study Design: Prospective observational study (n=74). Purpose: To evaluate the learning curve for exoscope and three-dimensional (3D) 4K hybrid visualization in terms of operating time, advantages, disadvantages, and surgical complications in tubular-access minimally invasive spine surgery (MISS) and to assess surgeon satisfaction with image quality, ergonomics, and ability to perform target site treatment. Overview of Literature: Working through tubular retractors poses a challenge. The extreme angulations during microsurgical decompression, especially contralateral decompression, require surgeons to work non-ergonomically. An exoscope allows surgeons to work ergonomically and independently of the microscope oculars as visualizations are now provided by large 3D 4K monitors. However, the value and efficacy of solely depending on an exoscope and 3D 4K monitors during microsurgical work are still unknown. Methods: Seventy-four patients (99 levels) underwent trans-tubular MISS between March 2018 and January 2019. Five patients were excluded: one had pyogenic discitis, two had revisions, and two were trans-tubular transoral. In total, we analyzed 69 for operating time, blood loss, and complications. The learning curve graph was plotted using the surgical time for each procedure. Surgeons were asked to rate their satisfaction with image quality, ability to maintain ergonomic posture, and efficient target site treatment. Results: For tubular microdiscectomy, the operating time plateaued after six cases, and for tubular decompression and minimally invasive transforaminal lumbar interbody fusion, the operating time plateaued after nine cases. Mean operating time was significantly reduced after the plateau. Complications included four cases of dural tear. All patients improved symptomatically, and there were no postoperative neurological deficits. Conclusions: Use of the exoscope has a short learning curve. Surgeons benefit from improved ergonomic posture during surgery, and resident teaching appears to be good. The only drawback is the need to rearrange the operating table setup. Complications were comparable to those when using the surgical microscope. An exoscope with hybrid digital visualization provides excellent visualization, depth perception, clarity, and precision target site treatment.
#Exoscope #Minimally invasive spine surgery

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참고문헌 (13)

참고문헌 신청
Williams RW / 1978 / Microlumbar discectomy : a conservative surgical approach to the virgin herniated lumbar disc / Spine 3:175~182 google schola Goald HJ / 1978 / Microlumbar discectomy : followup of 147patients / Spine 3:183~185 google schola Caspar W / 1991 / The Caspar microsurgical discectomy and comparison with a conventional standard lumbar disc procedure / Neurosurgery 28:78~86 google schola Overdevest GM / 2017 / Tubular discectomy versus conventional microdiscectomy for the treatment of lumbar disc herniation : long-term results of a randomised controlled trial / J Neurol Neurosurg Psychiatry 88:1008~1016 google schola Gempt J / 2013 / Long-term follow-up of standard microdiscectomy versus minimal access surgery for lumbar disc herniations / Acta Neurochir(Wien) 155:2333~2338 google schola

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