High-Definition 3-Dimensional Exoscope for 5-ALA Glioma Surgery: 3-Dimensional Operative Video. Issue 3 (7th June 2019)

• Record Type: Journal Article
• Authors: Doglietto, Francesco; Belotti, Francesco; Panciani, Pierpaolo; Poliani, Pietro Luigi; Fontanella, Marco Maria
• Is Part Of: Operative neurosurgery. Volume 18:Issue 3(2020)
• Page Start: E82
• Page End: E82
• Publication Date: 2019-06-07
• Subjects: 3-Dimensional -- 4 K -- 5-ALA -- Exoscope -- Glioma; Nervous system -- Surgery -- Periodicals; 617.480590
• DOI: 10.1093/ons/opz139
• Languages: English
• ISSNs: 2332-4252

Abstract

Abstract: A 54-yr-old man presented with the radiological recurrence of a glioblastoma at the level of the left anterior cingulate gyrus, 46 mo after first surgery, which had been complicated by bone flap infection. Due to the relatively small recurrence, the long survival, and the good neurological status, surgery was warranted. A new, high-definition (4 K) and 3-dimensional exoscope (ORBEYE; Sony Olympus Medical Solutions Inc, Tokyo, Japan) was used during the surgical approach and throughout tumor removal, which was aided by five-aminolevulinic acid (5-ALA) derived fluorescence. The postoperative course was characterized by supplementary motor area syndrome, which quickly improved, leading to a discharge home 1 wk after surgery. Histological examination confirmed a wild-type (WT) IDH1/2, MGMT (DNA repair enzyme O 6 -methylguanine-DNA methyltransferase) methylated glioblastoma with a proliferative index focally as high as 20%. He is now being considered for a second-line treatment. As recently reported for spinal surgery, 1 we believe this technology has significant potential for its small dimension (which can provide optimal positioning even in ergonomically challenging positions), ease of movement, and image quality, including 5-ALA fluorescence. The patient's consent was obtained for publication.