Can new-generation 4K exoscope surgery replace standard microscope surgery in neurosurgery?

Currently, neurosurgery is generally performed under a microscope. Improvements in microscope performance have greatly contributed to improved outcomes from neurosurgery. Recently, a new surgical instrument, the high-resolution exoscope system, has been commercialized and is being introduced to general neurosurgical practice. The exoscope was developed in the late 2010s as a system equipped with a video camera offering high sensitivity, high image quality, and 3D functions, and was introduced to the field of neurosurgery. Microscopes are designed to obtain an image of the surgical field captured by the objective lens through the eyepiece, with the large microscope device placed between the surgical field and the surgeon. The microscope is positioned in such a way that limits the range of movement of the microscope, and the eyepiece is only large enough for two people, the surgeon and their assistant. On the other hand, the video camera used in the exoscope can be positioned with a high degree of freedom, allowing the surgeon to obtain visual axes unobtainable with the microscope. In addition, because the video camera is positioned away from the surgical field, multiple people can participate in the surgical operation. Given these characteristics, exoscopes are considered likely to become more common in neurosurgery in the future. Using exoscope systems, neurosurgery is expected to become safer and achieve even better surgical results.