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CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(03): 634-637
DOI: 10.4103/ajns.AJNS_148_21
Case Report

Four hands surgery for intracerebral hemorrhage using orbeye: Educational values and ergonomic advantages – A technical note

Tomoaki Murakami
Department of Neurosurgery, Kansai Rosai Hospital, Amagaski, Hyogo
,
Shingo Toyota
Department of Neurosurgery, Kansai Rosai Hospital, Amagaski, Hyogo
,
Takuya Suematsu
Department of Neurosurgery, Kansai Rosai Hospital, Amagaski, Hyogo
,
Yuki Wada
Department of Neurosurgery, Kansai Rosai Hospital, Amagaski, Hyogo
,
Kanji Nakagawa
Department of Neurosurgery, Kansai Rosai Hospital, Amagaski, Hyogo
,
Takeshi Shimizu
Department of Neurosurgery, Kansai Rosai Hospital, Amagaski, Hyogo
,
Kanji Mori
Department of Neurosurgery, Kansai Rosai Hospital, Amagaski, Hyogo
,
Takuyu Taki
Department of Neurosurgery, Kansai Rosai Hospital, Amagaski, Hyogo
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We have developed a new educational approach to microsurgery in which a trainee and supervisor can cooperate with “4 hands” using the exoscope. We evaluated 4-hands surgery for intracranial hemorrhage (ICH) using the exoscope to validate the educational value and ergonomic advantages of this method. Thirty consecutive patients who underwent surgery for ICH using the exoscope between December 2018 and May 2020 were studied retrospectively. All operations were performed by a team comprising a supervisor (assistant) and a trainee (main operator). The assistant set the visual axis of the exoscope, and adjusted focus and magnification as a scopist. After setting the ORBEYE, the supervisor helped retract the brain and withdraw and irrigate the hematoma using suction tubes or brain retractors. Moreover, the trainee evacuated the hematoma with a suction tube and coagulated using bipolar forceps. Patient background and results of treatment were evaluated. Intraoperative postures of the operators were observed, and schemas compared with the use of a conventional microscope were developed. All microsurgical procedures were accomplished by a trainee with a supervisor using only the exoscope. During the surgery, the surgeons could work in a comfortable posture, and the supervisor and trainee could cooperate in microsurgical procedures using their four hands. The results of the present case series concerning evacuation of ICH were not inferior to those described in previous reports. To increase opportunities for education in microsurgery, 4-hands surgery for ICH using the exoscope appears feasible and safe and offered excellent educational value and ergonomic advantages.

Key-words:

Craniotomy - evacuation - exoscope - intracranial hemorrhage - ORBEYE

Financial support and sponsorship

Nil.




Publikationsverlauf

Eingereicht: 11. April 2021

Angenommen: 30. Mai 2021

Artikel online veröffentlicht:
16. August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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