High-definition three-dimensional exoscope for head and neck reconstruction: A prospective analysis of 27 consecutive patients

Purpose To analyze the advantages and disadvantages of a three-dimensional (3D) operating exoscope (OE) in head and neck free flap reconstruction. Methods Twenty-seven consecutive patients (females: 8; mean age: 57.0) were included. After each procedure, both surgeon and nurse were asked to fill out a tailored questionnaire on a three-point Likert scale including 12 items. Results All microvascular anastomoses were successfully completed, and no related complications were detected with a final free flap survival rate of 100% (mean follow-up of 5.6 months, SD: 3.1 months). The ergonomics, the ease of use, and the possibility to share the view among all the OR members were the best-rated items by the surgeons, while the luminance of the surgical field and the eye strain determined by the 3D glasses can still be improved. Conclusion Further comparative clinical studies are needed to clarify its real value in substitution to a conventional operating microscope.