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Enhancing Education and Ergonomics for the Cleft Surgeon Using a 3D Exoscope
Tobi J. Somorin, BS, Hakan Orbay, MD, PhD, Ethan Richlak, BS, Josh David, MD, Janina Kueper, MD, Ashley Rodgers, MD, and Jesse A. Goldstein, MD.
University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh
2025-01-09
Presenter: Tobi J. Somorin
Affidavit:
The entirety of this abstract submission represents the original work of the research team.
Director Name: Jesse A. Goldstein
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Background: Musculoskeletal injuries are common among cleft surgeons
as palatoplasties often require prolonged neck hyperflexion and thoracic kyphosis to visualize the oral cavity. Wearing loupes and headlights further strains the neck, while the restricted view of the confined oral cavity often limits visibility to the surgeon and first assistant. This study aims to assess whether a 4K 3D surgical microscope can improve ergonomic conditions and enhance teaching for fellows, residents, students, and operating room (OR) staff.
Methods: A 4K 3D Surgical Camera System is equipped with a dual-optics camera on a counterbalanced arm and fiber-optic LED lighting is maneuvered via a foot pedal
joystick for precision. A 31-inch 4K 3D monitor displayed the surgical view to the
surgeon, while a second 2D monitor allows visibility for others. We conducted an observational study with standardized subjective evaluations from surgeons, students, and OR staff after each procedure using the operative exoscope. Surveys used Likert scales to measure ease of use, image quality, ergonomic factors, and overall satisfaction.
Results: Four craniofacial surgeons reported that the exoscope supported a more natural posture and improved surgical workflow. They also reported that the learning curve for operating the exoscope was not challenging, and they experienced less fatigue during procedures. Learners expressed high satisfaction with the educational experience, feeling included in the surgery, and observing strong team collaboration and communication.
Conclusion: Preliminary survey results suggest these devices improve surgical visibility for team members, offer substantial educational benefits, and alleviate musculoskeletal strain typically associated with palatoplasties.
