PT  - JOURNAL ARTICLE
AU  - D'ERCOLE, MANUELA
AU  - SERCHI, ELENA
AU  - ZANELLO, MATTEO
AU  - TUFO, TOMMASO
AU  - STURIALE, CARMELO
TI  - Clinical Application of a High Definition Three-Dimensional Exoscope in Anterior Lumbar Interbody Fusion: Technical Note
AID  - 10.14444/7150
DP  - 2020 Dec 01
TA  - International Journal of Spine Surgery
PG  - 1003--1008
VI  - 14
IP  - 6
4099  - https://www.ijssurgery.com/content/14/6/1003.short
4100  - https://www.ijssurgery.com/content/14/6/1003.full
SO  - Int J Spine Surg2020 Dec 01; 14
AB  - Objectives: Video-assisted telescope operating monitor (VITOM) or exoscope is currently applied in different surgical specialties with clear visualization advantages in terms of magnification, illumination, and wide field of view. The small and deep surgical field of anterior lumbar interbody fusion (ALIF) seemed to be an ideal setting to assess efficacy of exoscope, also considering limits related to microscopic and endoscopic visualization currently employed.Methods: We reported our preliminary experience with exoscope in 9 cases of ALIF at L5-S1 level. These data were retrospectively compared with those obtained from an equal sample of ALIF procedures performed with endoscope as visualization instrument. The technical aspects taken into account were time for procedure and blood loss. Reports from the surgeon about ergonomics and confidence with both techniques were also evaluated.Results: Exoscope proved, in our experience, good visualization and ergonomics and unobstructed access to a small and deep surgical field, allowing abundant space to insert and manipulate the instruments.Conclusions: The instrument contained dimension and its long working distance, superior to endoscope and comparable with operating microscope, showed clear advantages of maneuverability. Moreover, the stereoscopic vision provided by 3-dimensional images proved to be crucial in hand-eye coordination.