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3D4K exoscope in epilepsy surgery: a seminal experience

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Abstract

Background and objectives

To report the progressive introduction of the exoscope (EX) from surface lesionectomy to antero-mesial temporal lobectomy (AMTL) in an epilepsy surgery practice.

Methods

We describe a population of ten consecutive patients undergoing EX surgery, with a minimum follow-up of 6 months, that was compared to a similar population of patients referred to operative microscopic surgery (OM).

Results

All surgeries were performed with the use of EX or OM alone. Transient neurological complications for surgery in eloquent regions were recorded in one patient for each population. Nine and seven patients undergoing, respectively, EX and OM surgery resulted in Engel class Ia (90% vs. 70%). The mean duration of EX and OM surgery resulted in 265.5 and 237.9 min, respectively, with a mean of 308.3 and 253.3 min for AMTL cases, respectively.

Conclusions

This preliminary study revealed that ORBEYE EX can be safe and effective in different types of epilepsy surgeries. The transition from OM to EX is fast, even though it is slower for the more challenging mesial temporal structure removal. Ergonomic and operative team interaction is improved by the use of EX. Our data need to be confirmed by larger studies.

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Data availability

The data were stored in a digital database and were collected during direct interviews with the patients during follow-up.

Code availability

Not applicable.

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Acknowledgements

This work was supported by the Italian Ministry of Health (RRC).

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Michele Rizzi, Nicolò Castelli, Vittoria Cojazzi, Niccolò Innocenti, Vincenzo Levi & Vittoria Nazzi

  2. Clinical and Experimental Epileptology and Sleep Disorders Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Giuseppe Didato

  3. Neuropathology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Gianluca Marucci

  4. Clinical Epileptology and Experimental Neurophysiology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy

    Rita Garbelli

Authors
  1. Michele Rizzi
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  2. Nicolò Castelli
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  3. Vittoria Cojazzi
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  4. Niccolò Innocenti
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  5. Vincenzo Levi
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  9. Vittoria Nazzi
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Contributions

Dr. MR wrote the first draft of this paper. Dr. NC, Dr. NI, Dr. VC, and Dr. VL helped with data curation. Dr. GD, Dr. RG, Dr. GM, and Dr. VN revised and edited the final version of the manuscript. All authors approved the final version before submission.

Corresponding author

Correspondence to Nicolò Castelli.

Ethics declarations

Ethics approval

Not applicable.

Consent to participate

All patients gave explicit consent to participate in this study.

Consent for publication

All patients had consented to the submission of this study to the journal.

Competing interests

Michele Rizzi and Nicolò Castelli occasionally serve as paid consultant testimony for WISE srl (manufacturer of strip for neuromonitoring). All other authors have nothing to disclose.

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Rizzi, M., Castelli, N., Cojazzi, V. et al. 3D4K exoscope in epilepsy surgery: a seminal experience. Acta Neurochir 165, 3921–3925 (2023). https://doi.org/10.1007/s00701-023-05885-z

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  • DOI: https://doi.org/10.1007/s00701-023-05885-z

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