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High-definition two-dimension video telescope operating monitor-assisted brain and spinal surgery in pediatrics: is it an acceptable substitute for microscopic surgery?

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A Correction to this article was published on 30 August 2022

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Abstract

Purpose

Vision and ergonomics are crucial variables for successful outcomes during neurosurgery procedures. Two-dimension video telescope operating monitor (VITOM) exoscope has emerged as an alternative, which is cheaper than microscope. The aim of this study is to evaluate the clinical utility of 2D VITOM and to compare its merits and demerits with respect to microscope.

Methods

VITOM 2D (Karl Storz, Germany) was used in 9 cranial and 5 spinal pediatric cases. While KINEVO operative microscope (Carl Zeiss, Germany) was used in 12 cranial and 6 spinal pediatric patients. All surgeries were performed by single senior neurosurgeon. The author’s experience and opinions, as well as qualitative data, were analyzed. A comparison was made on image quality, illumination, field of view, and magnification of the operative field and ergonomics.

Results

Seven out of 9 cranial pediatric cases were switched from VITOM 2D to operative microscope due to low-image definition in depth of cranial cavity. Poor visualization of bleeding source in surgical field was another major drawback. Two cranial cases in which exoscope were used exclusively, included superficial tumors. In all 5 spinal cases, VITOM 2D was successfully used without any major difficulty. The exoscope’s advantages were observed in ergonomics and ease in switching to naked eyes, but the microscope’s field of view, illumination, magnification, and user-friendliness was considered superior.

Conclusion

2D-VITOM is best suited for spinal and superficial cranial tumors. However, a lot of modifications are to be done especially in optics to become a substitute for operative microscope.

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Data availability

The data associated with the paper are not publicly available but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors acknowledge all our professors and consultants in department of Neurosurgery and Radiology for the guidance and assistance.

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Authors and Affiliations

  1. All India Institute of Medical Sciences, Phulwari Sharif, Patna, Bihar, 801507, India

    Anand Kumar Das, Suraj Kant Mani, Saraj Kumar Singh & Subhash Kumar

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  1. Anand Kumar Das
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Contributions

SKS contributed to the study conception and design. Material preparation, data collection, and analysis were performed by AKD, SKM, SKS, and SK. The first draft of the manuscript was written by AKD and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Saraj Kumar Singh.

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In this article Anand Kumar Das or Saraj Kumar Singh were denoted incorrectly as corresponding authors, but it should have been only Saraj Kumar Singh. The original article has been corrected.

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Das, A.K., Mani, S.K., Singh, S.K. et al. High-definition two-dimension video telescope operating monitor-assisted brain and spinal surgery in pediatrics: is it an acceptable substitute for microscopic surgery?. Childs Nerv Syst 38, 2171–2177 (2022). https://doi.org/10.1007/s00381-022-05636-y

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