Skip to main content

Advertisement

SpringerLink
Log in

Application of a 3D 4K exoscopic system to head and neck reconstruction: a feasibility study

  • Ideas and Innovations
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Technological advancements in surgery provide convenience and new capabilities to surgical practice. A recently developed 3D 4K exoscopic system gives the surgeon a potential alternative to the operating microscope (OM). This paper focuses on the first experience on microsurgical free flap reconstructions performed with a 3D 4K system and evaluates the potentials and pitfalls of this new technology.

Methods

Three consecutive cases of head and neck cancers requiring free flap reconstructions were included. Free flap harvesting and anastomosis in 2 and 3 patients, respectively, were performed using the 3D 4K exoscopic system.

Results

The 3D 4K exoscope provided a high quality of vision and perception of depth. The setting of the operating theater was ergonomically favorable. No case required a switch to traditional OM.

Conclusions

This initial experience shows that harvesting free flaps and performing microanastomoses with the 3D 4K exoscopic system are feasible. Further studies on larger series are warranted to explore if the applicability of this technology to other fields of head and neck surgery can compensate for its costs.

Level of Evidence: Level V, therapeutic study

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Quilici P, Greaney JE, Quilici J, Anderson S (1993) Laparoscopic inguinal hernia repair results: 131 cases. Am Surg 59(12):824–830

    CAS  PubMed  Google Scholar 

  2. McKenna RJ Jr, Mahtabifard A, Pickens A, Kusuanco D, Fuller CB (2007) Fast-tracking after video-assisted thoracoscopic surgery lobectomy, segmentectomy, and pneumonectomy. Ann Thorac Surg 84(5):1663–1668

    Article  Google Scholar 

  3. Marchioni D, Villari D, Mattioli F, Alicandri-Ciufelli M, Piccinini A, Presutti L (2013) Endoscopic management of attic cholesteatoma: a single-institution experience. Otolaryngol Clin North Am 46(2):201–209

    Article  Google Scholar 

  4. Rampinelli V, Doglietto F, Mattavelli D, Qiu J, Raffetti E, Schreiber A, Villaret AB, Kucharczyk W, Donato F, Fontanella MM, Nicolai P (2017) Two-dimensional high definition versus three-dimensional endoscopy in endonasal skull base surgery: a comparative preclinical study. World Neurosurg 105:223–231

    Article  Google Scholar 

  5. Nishiyama K (2017) From exoscope into the next generation. J Korean Neurosurg Soc 60(3):289–293

    Article  Google Scholar 

  6. Krishnan KG, Schöller K, Uhl E (2017) Application of a compact high-definition exoscope for illumination and magnification in high-precision surgical procedures. World Neurosurg 97:652–660

    Article  Google Scholar 

  7. Oertel JM, Burkhardt BW (2017) Vitom-3D for exoscopic neurosurgery: initial experience in cranial and spinal procedures. World Neurosurg 105:153–162

    Article  Google Scholar 

  8. Sack J, Steinberg JA, Rennert RC, Hatefi D, Pannell JS, Levy M, Khalessi AA (2018) Initial experience using a high-definition 3-dimensional exoscope system for microneurosurgery. Oper Neurosurg (Hagerstown) 14(4):395–401

    Article  Google Scholar 

  9. Belykh E, George L, Zhao X, Carotenuto A, Moreira LB, Yağmurlu K, Bozkurt B, Byvaltsev VA, Nakaji P, Preul MC (2018) Microvascular anastomosis under 3D exoscope or endoscope magnification: a proof-of-concept study. Surg Neurol Int 9:115

    Article  Google Scholar 

  10. Piatkowski AA, Keuter XH, Schols RM, van der Hulst RRWJ (2018) Potential of performing a microvascular free flap reconstruction using solely a 3D exoscope instead of a conventional microscope. J Plast Reconstr Aesthet Surg 71(11):1664–1678

    Article  Google Scholar 

  11. Kwan K, Schneider JR, Du V, Falting L, Boockvar JA, Oren J, Levine M, Langer DJ (2018) Lessons learned using a high-definition 3-dimensional exoscope for spinal surgery. Oper Neurosurg (Hagerstown). https://doi.org/10.1093/ons/opy196

    Article  Google Scholar 

  12. Mamelak AN, Nobuto T, Berci G (2010) Initial clinical experience with a high-definition exoscope system for microneurosurgery. Neurosurgery 67(2):476–483

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology—Head and Neck Surgery, University of Brescia, Piazzale Spedali Civili 1, 25123, Brescia, Italy

    Alberto Grammatica, Alberto Schreiber, Alperen Vural, Alberto Deganello, Marco Ferrari, Davide Lancini, Nausica Montalto & Piero Nicolai

  2. Department of Otorhinolaryngology—Head and Neck Surgery, University of Erciyes, Kayseri, Turkey

    Alperen Vural

Authors
  1. Alberto Grammatica
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alberto Schreiber
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alperen Vural
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alberto Deganello
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marco Ferrari
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Davide Lancini
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nausica Montalto
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Piero Nicolai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alberto Grammatica.

Ethics declarations

Conflict of interest statement

Author A and Author B declare that they have no conflict of interest.

Ethical approval

Ethical committee approval was obtained (SIC70601-602).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Funding

The system used in the surgeries was for a trial period. No financial or commercial relations are present between the authors and any of the companies mentioned in the text. No funding was received for the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

(m4v 213 mb)

(m4v 213 mb)

(m4v 183 mb)

(m4v 183 mb)

(m4v 142 mb)

(m4v 142 mb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Grammatica, A., Schreiber, A., Vural, A. et al. Application of a 3D 4K exoscopic system to head and neck reconstruction: a feasibility study. Eur J Plast Surg 42, 611–614 (2019). https://doi.org/10.1007/s00238-019-01521-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-019-01521-1

Keywords

Search

Navigation