3D-RoboticScope: surgery with a head movement

Surgery can be very strenuous for a surgeon, as he often has to bend over the patient in a rigid position for hours. For the first time worldwide, a surgical microscope that can be controlled by head movements was used at the University Hospital Zurich. This makes surgery not only more comfortable, but also faster.

In an interview with MEDICA-tradefair.com, Prof. Alexander Huber explains to what extent the digital microscope differs from an optical microscope, what is necessary for it and what the OR of the future will look like.

Professor Huber, what is the 3D RoboticScope? How does it work?

Prof. Alexander Huber: The 3D-RoboticScope is a new microscope for surgery that does not work optically, but digitally. After more or less 50 years of continuous development of the optical microscope, we have now arrived at a completely new generation of microscopes: the RoboticScope. The surgeon no longer works directly in the optical axis and controls the microscope, but sits at the operating table and controls the microscope through glasses. If he wants to take up a new position, for example to look more from below or more from above, he moves his head accordingly and looks at the spot where the robot then automatically steers.

What are the advantages compared to the conventional optical microscope?

Huber: I see a major advantage above all in the improved ergonomics. The surgeon can sit upright and does not have to bend over the patient. In addition, angles of view are achieved that are otherwise not available. The robot can even be directed to the opposite side. Conventionally, changing sides is not possible at all or only with great effort – on the one hand for reasons of sterility, on the other hand for reasons of space, because the instruments would then have to be moved, for example.

But we hope to save a lot of time during treatment in the future. First of all, it is still the case today that positioning the patient takes a lot of time because he has to be tilted. However, the RoboticScope is much more mobile than conventional microscopes, so that it can easily reach all sides of the patient without having to position the patient in a specific position and with a lot of time spent on it. Secondly, we can be faster because we can reach other angles with the RoboticScope. Thirdly, the glasses fold up and down automatically. The surgeon does not have to retract or extend the microscope every time he wants to have a brief overview. The eyeglasses fold up, the robot moves away and can then return to exactly the same position.

So, the advantages of RoboticScope are: better ergonomics, better viewing angles and thus time savings.

What has to be taken into account during application? Are there certain requirements?

Huber: You have to get used to it. That is certainly still the biggest challenge at the moment. This is especially true for experienced surgeons who have used conventional microscopes for years. For this purpose, we are planning a training station, comparable to a video game, where you can familiarize yourself with the new system, the glasses and, above all, the control system. Beyond that, we do not see any limitations. Once the surgeon has become familiar with it, it will be suitable for all applications where a conventional microscope has been used up to now.

What do you think the OR of the future looks like?

Huber: I am convinced that the OR of the future will be very much complemented by technology. At the moment, this is not yet the case everywhere, but there are already some developments in this direction. In Berne, for example, an independent robot for cochlear implants has been developed. We will of course have to see how this becomes clinically established. But I am sure that such robots will assist us in the future – perhaps not always and everywhere, but at least for certain activities. I also believe that augmented reality will play an important role in surgery. In the RoboticScope, for example, AR is to be integrated perspectively.