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New Technology at UM Health-West Provides a View of the Future of Neurosurgery

The next generation of microsurgery is crystal clear, bigger than life and visible in high-resolution 3D at University of Michigan Health-West, where the intricate work of neurosurgeons can now be seen by everyone in the operating room.

This means better workflows for surgical teams – and ergonomic relief for neurosurgeons. Thanks to a combination of robotics and augmented reality, neurosurgeons no longer need to hunch over microscopes for hours while twisting their bodies into the best angle to work on the brain, spinal cord and nerves.

The Aesculap Aeos Robotic Digital Microscope, obtained with funding from the University of Michigan Health-West Foundation, offers multiple advantages to the UM Health-West Neurosciences team. In addition to showing microscopic views on monitors in the OR, it provides precise robotic-guided positioning, 3D imaging and “fluorescence” to light up tumors, aneurysms, tissues or other target areas.

“This is an amazing technology for the innovative work we do and great support for our team,” said Chief Medical Officer Dr. Ronald Grifka. “In traditional microsurgery, the surgeon might have to keep their head tilted at a 60-degree angle for hours at a time. We know they can perform better for their patients – and have greater job satisfaction – if they are comfortable and relaxed when performing these intricate neurosurgeries.”

In a 2020 survey published in World Neurosurgery, more than 73% of neurosurgeons said they had experienced work-related musculoskeletal disorders. With procedures that can last 6, 7, 8 hours or more, neurosurgeons and their operating room teams must often endure physical pain but still perform with great precision.

Neurosurgeon Bryan Figueroa, MD, welcomes the ergonomic relief but said the contribution to teamwork is what makes the system a game-changer. He cited a recent example where he collaborated with an ear, nose and throat surgeon to treat a patient.

“Everybody could see what was happening with the operation,” Figueroa said, noting surgeries might require a team of seven to 10 people working simultaneously. “It’s like conducting a symphony. When we all can anticipate what needs to happen next, response time is faster, and we can stay perfectly in synch to optimize patient care.”

The technology has potential applications for many other microsurgeries, such as plastic surgery, ophthalmology, even reconstructive surgery of the hand. It’s also a great advance for teaching, as surgical residents can now see what the surgeon sees.

“We’re grateful for a progressive Foundation that decided to invest in this technology,” Figueroa said. “This is really the next generation of microsurgery.”

See a video demonstration of the Aesculap Aeos Robotic Digital Microscope.