VITOM 3D: Preliminary Experience in Cranial Surgery

Z. Rossini, A. Cardia, D. Milani, G.B. Lasio, M. Fornari, V. D'Angelo

Research output: Contribution to journalArticlepeer-review


Background Optimal vision and ergonomics are important factors contributing to achievement of good results during neurosurgical interventions. The operating microscope and the endoscope have partially filled the gap between the need for good surgical vision and maintenance of a comfortable posture during surgery. Recently, a new technology called video-assisted telescope operating monitor or exoscope has been used in cranial surgery. The main drawback with previous prototypes was lack of stereopsis. We present the first case report of cranial surgery performed using the VITOM 3D, an exoscope conjugating 4K resolution view and three-dimensional technology, and discuss advantages and disadvantages compared with the operating microscope. Case Description A 50-year-old patient with vertigo and headache linked to a petrous ridge meningioma underwent surgery using the VITOM 3D. Complete removal of the tumor and resolution of symptoms were achieved. The telescope was maintained over the surgical field for the duration of the procedure; a video monitor was placed at 2 m from the surgeons; and a control unit allowed focusing, magnification, and repositioning of the camera. Conclusions VITOM 3D is a video system that has overcome the lack of stereopsis, a major drawback of previous exoscope models. It has many advantages regarding ergonomics, versatility, and depth of field compared with the operating microscope, but the holder arm and the mechanism of repositioning, refocusing, and magnification need to be ameliorated. Surgeons should continue to use the technology they feel confident with, unless a distinct advantage with newer technologies can be demonstrated. © 2017 Elsevier Inc.
Original languageEnglish
Pages (from-to)663-668
Number of pages6
JournalWorld Neurosurgery
Publication statusPublished - 2017


  • Exoscope
  • High quality vision
  • New technology in cranial neurosurgery
  • VITOM 3D
  • adult
  • Article
  • case report
  • clinical article
  • craniectomy
  • equipment design
  • ergonomics
  • exoscope
  • forceps
  • headache
  • human
  • meningioma
  • microsurgery
  • middle aged
  • neurological surgical equipment
  • nuclear magnetic resonance imaging
  • risk benefit analysis
  • skull surgery
  • surgical microscope
  • surgical technique
  • vertigo
  • craniotomy
  • devices
  • endoscopic surgery
  • evaluation study
  • headache and facial pain
  • neurosurgery
  • telescope
  • three dimensional imaging
  • Craniotomy
  • Headache Disorders
  • Humans
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging
  • Meningeal Neoplasms
  • Meningioma
  • Middle Aged
  • Neurosurgical Procedures
  • Telescopes
  • Vertigo
  • Video-Assisted Surgery


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