The first comprehensive review of surgical microscopes details the technical history and prospects of the ever-evolving surgical microscopes
SPIE--International Society of Optics and Photonics
Image: Surgical microscope with integrated near-infrared photoacoustic OCT, from D. Lee et al., doi 10.1038/srep35176 Read more
Image source: D. Lee et al., doi 10.1038/srep35176
A clear view of the anatomy is critical to the success of the operation-especially in microsurgery, narrow anatomical cavities or close proximity to fragile organs and tissues pose a major risk to the patient's health. The surgical microscope has developed into a powerful tool to improve the visualization of surgery.
A comprehensive review of surgical microscopes written by Fei Baowei, a professor of bioengineering and radiology at the University of Texas at Dallas, and Ma Ling, a doctoral student in bioengineering, introduced the evolution of surgical microscopes with wider magnification and longer working distances. Better lighting and more stable support structure. Ma and Fei explained how to modify surgical microscopes into slightly different optical configurations and equip them with specific imaging modes and platforms for different surgical applications.
In 1921, a young ENT surgeon named Carl Olof Nylén at Stockholm University used the first operating room operating microscope. Nylén used a monocular Brinell microscope during surgery on a patient with a chronic ear infection. This is a step beyond the single-lens magnifying glass. A year later, Gunnar Holmgren updated the tool. He developed a binocular microscope for depth perception and an additional light source for magnification. Holmgren hardly recognizes today's surgical microscopes with adjustable magnification, bright and shadow-free illumination, variable working distances to allow operation of surgical instruments, and a stable, unobstructed view of the entire surgical area.
Although the operating microscope was not introduced into the neurosurgery operating room until 1957, when Theodor Kurze of the University of Southern California removed a benign tumor from the brain nerve of a 5-year-old patient, neurosurgery is now The main market for surgical microscopes.
Multifunctional visualization, integrated imaging mode
Surgical microscopes have come a long way. In addition to high-precision optics and flexible mechanical design, it now also includes multi-functional visualization functions such as 3D display, as well as integrated imaging modes. The augmented reality display superimposes real-life structures and MRI or OCT images of the structure, improving the visualization of the surgical field and multi-modal images. This advanced function is changing the clinical practice of the operating room, enabling surgeons to better see and perform challenging operations more easily and successfully.
Hyperspectral imaging (HSI) and laser speckle contrast imaging (LSCI) modes are particularly promising because they can be used on-demand at any time during surgery and provide rich real-time diagnostic data as non-contact and label-free imaging modes. Ma and Fei pointed out that both HSI and LSCI add little complexity to the system, and the workload used by doctors is very small.
The visualization functions and integration technologies in surgical microscopes continue to expand. With the help of advanced communication technology and a complete augmented reality assistance platform, large groups will be able to remotely participate in the surgical process and share a clear surgical vision through headsets, smartphones or large conference room screens.
The robotic visualization platform allows the surgeon to move freely and enables the entire team to observe detailed structures. Integrated technologies, such as endoscopic microscopy tools, can enable surgeons to "mark" the location of the surgical field and visualize the same structure from different angles. Such a system enriches the concept of surgical microscopes through a number of cutting-edge technologies, and provides obvious advantages in terms of time, function and ergonomics.
Operating microscopes were first used in otolaryngology and are contributing to various microsurgery operations ranging from lymphatic reconstruction to nerve repair. It can be expected that more and more surgical microscopes will be used clinically, as well as a wider range of surgical applications.
Read the open access review paper: Ling Ma and Baowei Fei, "Comprehensive Review of Surgical Microscopes: Technology Development and Medical Applications", J. Biomed. choose. 26(1) 010901 (2021), doi 10.1117/1.JBO.26.1.010902.
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SPIE--International Society of Optics and Photonics
Copyright © 2021 American Association for the Advancement of Science (AAAS)
Copyright © 2021 American Association for the Advancement of Science (AAAS)