Vascular Ultramicroneurosurgery under the Exoscope

Context: Neurosurgery is being revolutionised with the introduction of the exoscope, an advanced surgical instrument that exceeds the capabilities of conventional operating microscopes in magnification power, ergonomics, and compatibility with sophisticated technologies. Providing up to ×70 magnification and 4K three-dimensional visualisation, it offers improved visualisation and surgeon comfort through ergonomic, heads-up displays. Its easy compatibility with artificial intelligence (AI) and hypervision overlays allows real-time guidance, enhanced accuracy and safer surgical results. Developments such as the Sahasra Netra system further enhance intraoperative decision-making using predictive analytics and AI monitoring. Results: Clinical evidence attests to the effectiveness of the exoscope in minimising complications and decreasing learning curves for trainees. As much as there were initial adaptation and cost obstacles, continued development towards mobility and robotic support is overcoming them. With pioneering achievements in ultramicroneurosurgery and hypervision, the exoscope is set to become neurosurgery’s new standard, delivering unrivaled clarity, precision and intelligence in the operating room. Conclusions: The exoscope is redefining the way neurosurgery is performed, offering a level of visualisation, ergonomic comfort and technological integration that was previously unimaginable. With ultramicroneurosurgery, hypervision and AI-driven innovations like Sahasra Netra, we are stepping into a new era of neurosurgical precision – one where every detail is magnified, every move is optimised and every patient has the best possible chance of recovery. The future of neurosurgery is not just bright – it’s ultra-clear, ultra-magnified and ultra-intelligent.