ArticleArchives of plastic surgery2020
The Exoscope versus operating microscope in microvascular surgery: A simulation non-inferiority trial.
Article in Archives of plastic surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 56 citations in OpenAlex.
- Lymphovenous Bypass: Past, Present, and Future.Archives of plastic surgery · 2026Article
- Expanding Horizons in Craniomaxillofacial Reconstruction: The Role of Exoscopic Microsurgery in Head and Neck Surgery.Craniomaxillofacial trauma & reconstruction · 2026Article
- Enhancing submandibular gland resection: A retrospective study on the efficacy of the ORBEYE 3D exoscope.Oral and maxillofacial surgery · 2025Article
- Exoscopes in Neurosurgery: A Bibliometric and Visualization Analysis.Asian journal of neurosurgery · 2025Review
- Review
- Post-operative monitoring of tissue perfusion in murine skin flaps using enhanced thermal imaging.Biomedical optics express · 2025Article
- Comparison of operative microscope and exoscope for execution of microanastomoses on an artificial model.Frontiers in surgery · 2025Article
- Application of the ORBEYE Three-Dimensional Exoscope for Parotidectomies.Journal of clinical medicine · 2024Article
- Microscopic subinguinal varicocelectomy with video telescopic operating microscope (VITOM) telescope: outcome analysis.Translational andrology and urology · 2024Article
- Even short-term training improves the skills of novice exoscope users: a prospective laboratory experiment.Acta neurochirurgica · 2024Article
- From Microscopic to Exoscopic Microsurgery: Are We Facing a Change of Paradigm?Advances and technical standards in neurosurgery · 2024Article
- Video exoscope as a cost-effective alternative to surgical microscope in microsurgical subinguinal varicocelectomy in Indonesia: A case report.Urology case reports · 2023Article
- Intraoperative Imaging and Optical Visualization Techniques for Brain Tumor Resection: A Narrative Review.Cancers · 2023Review
- Assessing the Training in Neurosurgery with the Implementation of VITOM-3D Exoscope: Learning Curve on Experimental Model in Neurosurgical Practice.Brain sciences · 2023Article
- Binocular microscopes versus exoscopes: Experiences and performance in simulated otologic surgery.Laryngoscope investigative otolaryngology · 2023Article
- A Sensorised Surgical Glove to Analyze Forces During Neurosurgery.Neurosurgery · 2023Article
- 3D Exoscopes in Experimental Microanastomosis: A Comparison of Different Systems.Life (Basel, Switzerland) · 2023Article
- Learning Curve and Ergonomics Associated with the 3D-monitor-assisted Microsurgery Using a Digital Microscope.Journal of plastic and reconstructive surgery · 2023Article
- Minimally invasive treatment for glioblastoma through endoscopic surgery including tumor embolization when necessary: a technical note.Frontiers in neurology · 2023Article
- Using 3D Microscope for Hepatic Artery Reconstruction in Living Donor Liver Transplant.Journal of clinical medicine · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Exoscope is a novel high-definition digital camera system. There is limited evidence signifying the use of exoscopic devices in microsurgery. This trial objectively assesses the effects of the use of the Exoscope as an alternative to the standard operating microscope (OM) on the performance of experts in a simulated microvascular anastomosis.
methodsModus V Exoscope and OM were used by expert microsurgeons to perform standardized tasks. Hand-motion analyzer measured the total pathlength (TP), total movements (TM), total time (TT), and quality of end-product anastomosis. A clinical margin of TT was performed to prove non-inferiority. An expert performed consecutive microvascular anastomoses to provide the exoscopic learning curve until reached plateau in TT.
resultsTen micro sutures and 10 anastomoses were performed. Analysis demonstrated statistically significant differences in performing micro sutures for TP, TM, and TT. There was statistical significance in TM and TT, however, marginal non-significant difference in TP regarding microvascular anastomoses performance. The intimal suture line analysis demonstrated no statistically significant differences. Non-inferiority results based on clinical inferiority margin (Δ) of TT=10 minutes demonstrated an absolute difference of 0.07 minutes between OM and Exoscope cohorts. A 51%, 58%, and 46% improvement or reduction was achieved in TT, TM, TP, respectively, during the exoscopic microvascular anastomosis learning curve.
conclusionsThis study demonstrated that experts' Exoscope anastomoses appear non-inferior to the OM anastomoses. Exoscopic microvascular anastomosis was more time consuming but end-product (patency) in not clinically inferior. Experts' "warm-up" learning curve is steep but swift and may prove to reach clinical equality.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.