Prospective study of the application of a 3D exoscope system (VITOM 3D) in ear surgery compared to conventional surgical microscopes: part I - analysis of objective parameters.

IF 1.9 3区医学 Q2 OTORHINOLARYNGOLOGY European Archives of Oto-Rhino-Laryngology Pub Date : 2024-11-22 DOI:10.1007/s00405-024-09096-9

Hai Yen Tao, Joseph Morgenstern, Christoph Müller, Nikoloz Lasurashvili, Thomas Zahnert, Thomas Beleites, Marcus Neudert

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Abstract

Background: This prospective study compared the application of a 3D exoscope (VITOM 3D) with surgical microscopes (SM) in ear surgery.

Methods: 62 patients were included (exoscope group (E+) n = 31; SM group (E-) n = 31). Procedures included cochlea implantation (nE + = 10, nE- = 10), reconstructive middle ear surgery due to chronic otitis media with (COMwC; nE + = 11, nE- = 11) and without cholesteatoma (COMsC; nE + = 10, nE- = 10). Objective (e.g. set-up time and wrap-up time, corrected cut-suture-time, pure operating time, adjustment time, time per adjustment procedure, learning curves) and subjective perioperative parameters were evaluated. This paper only addressed the analysis of the objective parameters.

Results: The pooled data showed that the mean time delay in the E + group was significantly higher compared to the E- group with regard to set-up time and wrap-up time, corrected cut-suture time, adjustment time and time per adjustment procedure. Time delay tended to be higher for pure operating time. In all subgroups of the E + group, the objective time parameters also showed at least a tendency to be prolonged on average compared to the corresponding subgroups in the E- group. The learning curve analysis showed that the E + group (corrected cut suture time for CI surgery, mean time per adjustment procedure across all subgroups) approached the times of the E- group during the course of the study.

Conclusions: Based on the pooled data from the study arms, the exoscope tends to be inferior to the microscope for the objective time parameters evaluated when used in ear surgery. However, due to the small group sizes, no solid conclusions could be drawn regarding the individual surgical procedures. In addition, further studies with a longer observation period are needed to minimize the influence of the learning curve on the results.

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三维外窥镜系统（VITOM 3D）在耳科手术中的应用与传统手术显微镜比较的前瞻性研究：第一部分 - 客观参数分析。

背景：这项前瞻性研究比较了三维外窥镜（VITOM 3D）和手术显微镜（SM）在耳科手术中的应用。方法：共纳入 62 例患者（外窥镜组（E+）n = 31；手术显微镜组（E-）n = 31）。手术包括耳蜗植入术（nE + = 10，nE- = 10）、有（COMwC；nE + = 11，nE- = 11）和无胆脂瘤（COMsC；nE + = 10，nE- = 10）慢性中耳炎引起的中耳重建手术。对客观参数（如设置时间和包扎时间、校正切割缝合时间、纯操作时间、调整时间、每次调整时间、学习曲线）和围术期主观参数进行了评估。本文仅对客观参数进行了分析：汇总数据显示，E+组在准备时间和包扎时间、校正切开缝合时间、调整时间和每次调整时间方面的平均时间延迟明显高于E-组。纯操作时间的延迟往往更高。在 E + 组的所有分组中，与 E- 组的相应分组相比，客观时间参数至少也有平均延长的趋势。学习曲线分析表明，在研究过程中，E+组（CI手术的校正切口缝合时间、所有亚组每次调整手术的平均时间）接近E-组的时间：根据各研究臂的汇总数据，在耳科手术中使用外窥镜进行客观时间参数评估时，外窥镜往往不如显微镜。然而，由于研究组规模较小，因此无法就个别手术程序得出可靠的结论。此外，还需要进行观察期更长的进一步研究，以尽量减少学习曲线对结果的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Archives of Oto-Rhino-Laryngology 医学-耳鼻喉科学

CiteScore

5.30

自引率

7.70%

发文量

537

审稿时长

2-4 weeks

期刊介绍： Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.