Application of a three-dimensional high-definition exoscope in minimally invasive transforaminal lumbar interbody fusion

Abstract Background Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is becoming increasingly popular in the treatment of lumbar degenerative diseases. Microscope assisted MIS-TLIF was also reported favorable clinical outcomes and low complication rates, while limitations can include depth of field, illumination, and ergonomics. The exoscope has been introduced as an alternative to microscopes. In this report, we describe the application of the 3-dimensional (3D), high-definition (HD) exoscope for MIS-TLIF, and discuss its advantages and disadvantages. Methods Six patients were performed 3D-HD exoscope-assisted MIS-TLIF from September 2019 to December 2019. The exoscope was used [Kestrel View II, WEALTH CONCORD MITAKA MEDICAL TECHNOLOGIESCO., LTD. OF SHANGHAI, CHINA] during soft tissue dissection, discectomy, decompression, and cage insertion. Results The exoscope provided an excellent 3D view of the surgical field and allowed us to effectively and safely perform the surgical steps. All 6 patients experienced excellent surgical outcomes. The main advantages of the 3D exoscope include the possibility to provide excellent, magnified, and illuminated 3D-HD images of the surgical field to the entire operating room and serving as an excellent training tool. Conclusion We believe that the 3D exoscope will be a safe and effective tool to perform MIS-TLIF.