[The development of three dimensional video microscope system for clinical application in neurosurgery].
OBJECTIVE
The employment of surgical microscopy in the field of neurosurgery has significantly contributed not only to the advancement of surgical technique, but also the operative outcome as well. This technology has allowed surgeons to meet the demands for increasingly difficult levels of surgery, which usually require a long operative time. However, the surgeon and the assistant are restricted in their posture for a long time, leading to excessive muscular and ocular stress. To solve these problems, we have developed and clinically applied a three dimensional video microscope system for surgery, using a two binocular camera method, that allows surgical procedures to be performed over a video monitor.


METHODS
Two 3CCD cameras were installed on the assistant's lens attachment and the camera lens attachment of the microscope for neurosurgery, manufactured by Carl Zeiss Co., Ltd. The surgery was performed by viewing the three dimensional picture on the monitor, which was created by processing the images from the cameras by a time-division method. In November 1998, the prototype was completed and, with numerous modifications, its clinical application has become possible. Currently, we have used it in 42 clinical cases.


RESULTS
1) Instead of viewing the surgical field through a conventional surgical microscope, the surgeon and the assistant were able to perform microsurgery by viewing the stereoscopic vision on the video monitor, through polarized glasses. 2) The assistant is provided with a separate video monitor, so that the assistant can freely adjust the angle of vision 90-180 degrees, according to where he stands. 3) The nurses, resident surgeons and students can view the same three dimensional images displayed to the surgeon. This effectively contributes to the educational environment.


CONCLUSIONS
Even during a long surgical procedure, the posture of surgeon and assistant became less restricted since there was no need to look through the eyepiece of the microscope and led to significant decrease in physical fatigue and ocular strain. In the 42 clinical trials, the operation proceeded uneventfully, without any serious complications.
Seiki
Yoshikatsu
Y
1st Department of Neurosurgery, Toho University, School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan.
Shibata
Iekado
I
Oishi
Hitoshi
H
Sanpei
Kenji
K
Kano
Toshiyuki
T
Utagawa
Teruzo
T
Fukuyo
Tsuneo
T
D001927:Brain Diseases / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D018715:Microscopy, Video; D009493:Neurosurgery / Q000295:instrumentation*; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods