Journal: Journal of Robotic Surgery

Article Title: Exoscopic-assisted head and neck surgery: a comparative evaluation optimizing ergonomics and workflow

doi: 10.1007/s11701-025-02551-7

Figure Lengend Snippet: a Three-Dimensional (3D) glasses for the KINEVO® 900 S from ZEISS which allow for 3D-view on the system`s two monitors, b Head-mounted display (HMDmd) for the ZEISS KINEVO 900 S with visualization of the surgical field in 3D without the necessity of a direct view of the monitors for visualization, c Foot pedal for the ZEISS KINEVO 900 S with customizable buttons allowing for a hands-free control of the exoscope

Article Snippet: Fig. 1 a Three-Dimensional (3D) glasses for the KINEVO® 900 S from ZEISS which allow for 3D-view on the system`s two monitors, b Head-mounted display (HMDmd) for the ZEISS KINEVO 900 S with visualization of the surgical field in 3D without the necessity of a direct view of the monitors for visualization, c Foot pedal for the ZEISS KINEVO 900 S with customizable buttons allowing for a hands-free control of the exoscope In addition, the system includes a head-mounted display (HMDmd), as shown in Fig. b, which is wired to the operating microscope and allows the surgical assistant to visualize the surgical field in 3D.

Techniques: Control

Journal: Journal of Robotic Surgery

Article Title: Exoscopic-assisted head and neck surgery: a comparative evaluation optimizing ergonomics and workflow

doi: 10.1007/s11701-025-02551-7

Figure Lengend Snippet: Operation room setup with placement of the KINEVO® 900 S from ZEISS. The ZEISS KINEVO 900S is seen in sterile draping, the oculars and the hand bars are still attached. The ZEISS KINEVO 900S is placed in adequate distance from the surgical field, without interfering with the surgeons’ movements or the surgical field. The figure shows exemplarily a a cochlear implant surgery, the surgeon on the left side is currently conduction mastoidectomy, both the surgeon and the assistant wear 3D-glasse, b the conduction of a microvascular anastomosis with the usage of the 3-D glasses for both surgeon and assistant currently conducting the venous anastomosis of a radial free flap and c a parotidectomy with the assisting surgeon using the Head-mounted display (HMDmd). The system is currently limited to the two presented monitors, the assisting surgeon is not looking at a third monitor, the visualization of the surgical field is possible with the HMDmd only

Article Snippet: Fig. 1 a Three-Dimensional (3D) glasses for the KINEVO® 900 S from ZEISS which allow for 3D-view on the system`s two monitors, b Head-mounted display (HMDmd) for the ZEISS KINEVO 900 S with visualization of the surgical field in 3D without the necessity of a direct view of the monitors for visualization, c Foot pedal for the ZEISS KINEVO 900 S with customizable buttons allowing for a hands-free control of the exoscope In addition, the system includes a head-mounted display (HMDmd), as shown in Fig. b, which is wired to the operating microscope and allows the surgical assistant to visualize the surgical field in 3D.

Techniques: Sterility

Journal: Journal of Robotic Surgery

Article Title: Exoscopic-assisted head and neck surgery: a comparative evaluation optimizing ergonomics and workflow

doi: 10.1007/s11701-025-02551-7

Figure Lengend Snippet: Surgeons’ evaluation (n = 8) of the KINEVO® 900 S according to a custom evaluation questionnaire handed to each surgeon after surgery. a Summary of the surgeons’ evaluation concerning the comparison of the ZEISS KINEVO 900 S with other standard magnification devices (binocular microscope and surgical loupes). The surgeons rated on a 5-point Likert-scale which device was favored depending on the conducted surgery depending on different rating categories like the depth of the surgical field or illumination. The assessment was conducted for each type of surgery separately, in case of different answers from the surgeons a median value was formed. M = microvascular anastomosis, P = parotidectomy, E = ear surgery. 1 = microscope/surgical loupes clearly favored, 2 = microscope/surgical loupes slightly better, 3 = neutral, 4 = exoscope slightly better, 5 = exoscope clearly favored, b Assessment of the pros and cons of the ZEISS KINEVO 900 S concerning comfort and feasibility rated on a 5-point Likert-scale. In case of different answers from the surgeons a median value was formed. 1 = very poor/strongly disagree, 2 = poor/disagree, 3 = neutral, 4 = good/agree, 5 = very good/strongly agree

Article Snippet: Fig. 1 a Three-Dimensional (3D) glasses for the KINEVO® 900 S from ZEISS which allow for 3D-view on the system`s two monitors, b Head-mounted display (HMDmd) for the ZEISS KINEVO 900 S with visualization of the surgical field in 3D without the necessity of a direct view of the monitors for visualization, c Foot pedal for the ZEISS KINEVO 900 S with customizable buttons allowing for a hands-free control of the exoscope In addition, the system includes a head-mounted display (HMDmd), as shown in Fig. b, which is wired to the operating microscope and allows the surgical assistant to visualize the surgical field in 3D.

Techniques: Comparison, Microscopy

Journal: Journal of Robotic Surgery

Article Title: Exoscopic-assisted head and neck surgery: a comparative evaluation optimizing ergonomics and workflow

doi: 10.1007/s11701-025-02551-7

Figure Lengend Snippet: Intraoperative exoscopic image of the ZEISS KINEVO 900S in a case of cochlea implant surgery after mastoidectomy, antrostomy and cochleostomy ( a ) and insertion of the cochlear electrode into the round window ( b ), in tympanoplasty after mastoidectomy and antrostomy with visualization of the stapes suprastructure and the long process of the incus ( c ) and after placement of an angular clip protheses connecting the long process of the incus with the stapes suprastructure ( d ). round window visible after mastoidectomy, Cochlea Implant electrode inserted into the round window, chorda tympani, stapes superstructure, long process of the incus, angular clip prothesis connecting the long process of the incus and the stapes superstructure

Article Snippet: Fig. 1 a Three-Dimensional (3D) glasses for the KINEVO® 900 S from ZEISS which allow for 3D-view on the system`s two monitors, b Head-mounted display (HMDmd) for the ZEISS KINEVO 900 S with visualization of the surgical field in 3D without the necessity of a direct view of the monitors for visualization, c Foot pedal for the ZEISS KINEVO 900 S with customizable buttons allowing for a hands-free control of the exoscope In addition, the system includes a head-mounted display (HMDmd), as shown in Fig. b, which is wired to the operating microscope and allows the surgical assistant to visualize the surgical field in 3D.

Techniques:

Journal: Journal of Robotic Surgery

Article Title: Exoscopic-assisted head and neck surgery: a comparative evaluation optimizing ergonomics and workflow

doi: 10.1007/s11701-025-02551-7

Figure Lengend Snippet: Intraoperative exoscopic image of the ZEISS KINEVO 900S during laterocaudal parotidectomy a with visualization of the facial nerve, the tumor mass is resected with the lateral part of the parotid gland, b resection of a parotid tumor mass. Intraoperative exocopic image during microvascular anastomosis of a radial free flap for reconstruction of an oropharyngeal defect after tumor resection ( c + d ) with arterial anastomosis of the radial artery and the superior thyroid artery ( c ) and venous anastomosis of the internal jugular vein and the median cubital vein ( d ). Facial nerve, tumor, healthy parotid tissue, Radial artery, superior thyroid artery, internal jugular vein, median cubital vein

Article Snippet: Fig. 1 a Three-Dimensional (3D) glasses for the KINEVO® 900 S from ZEISS which allow for 3D-view on the system`s two monitors, b Head-mounted display (HMDmd) for the ZEISS KINEVO 900 S with visualization of the surgical field in 3D without the necessity of a direct view of the monitors for visualization, c Foot pedal for the ZEISS KINEVO 900 S with customizable buttons allowing for a hands-free control of the exoscope In addition, the system includes a head-mounted display (HMDmd), as shown in Fig. b, which is wired to the operating microscope and allows the surgical assistant to visualize the surgical field in 3D.

Techniques:

Journal: Journal of Robotic Surgery

Article Title: Exoscopic-assisted head and neck surgery: a comparative evaluation optimizing ergonomics and workflow

doi: 10.1007/s11701-025-02551-7

Figure Lengend Snippet: a Setup of the ZEISS KINEVO 900S during parotidectomy using the Head-Mounted Display (HMDmd). The green line illustrates the assistant’s direct line of sight to the surgical field via the HMDmd. The red line indicates the angle of neck anteflexion (approximately 30–40°) that would be required without the HMD to observe the surgical field without the exoscope. b Alternative setup using 3D glasses and external monitor (example from radial free flap surgery). This configuration is ergonomically acceptable but less favorable for parotidectomy, where continuous monitoring of facial movements is essential. The assistant must turn away from the patient’s face to view the monitor, limiting simultaneous nerve monitoring

Article Snippet: Fig. 1 a Three-Dimensional (3D) glasses for the KINEVO® 900 S from ZEISS which allow for 3D-view on the system`s two monitors, b Head-mounted display (HMDmd) for the ZEISS KINEVO 900 S with visualization of the surgical field in 3D without the necessity of a direct view of the monitors for visualization, c Foot pedal for the ZEISS KINEVO 900 S with customizable buttons allowing for a hands-free control of the exoscope In addition, the system includes a head-mounted display (HMDmd), as shown in Fig. b, which is wired to the operating microscope and allows the surgical assistant to visualize the surgical field in 3D.

Techniques: