Excision of a median nerve schwannoma using the 3D microscope: a heads-up ergonomic approach to microsurgical tasks in hand surgery

Recent advances in technology and refinement of surgical techniques have facilitated exponential growth in the field of microsurgery. However, use of the traditional binocular microscope can expose surgeons to excessive neck and body fatigue that cause work-related musculoskeletal injuries. Thereby, ergonomic errors that lead to musculoskeletal symptoms can have a significant impact on performance in the operating room as well as home and work life. With the introduction of multi-imaging technologies, "heads-up", a new 3-dimensional (3D) viewing system, allows the microsurgeon to operate in a physiologically comfortable position. Despite favourable reports in neurosurgery, it is yet to be scientifically determined whether the three-dimensional heads-up display technology may be unconditionally employed for more complex hand surgery such as an excision of a median nerve tumour. The following case report illustrates the utility of this technology, as an operative and education tool in the field of hand surgery.