• Kenichi Nishiyama, Yoshihiro Natori, and Kazunari Oka.
• Brain Research Institute, University of Niigata, Asahimachi 1-757, Niigata, 951-8585, Japan, nishiken@d4.dion.ne.jp.
• Acta Neurochir (Wien). 2014 Jun 1; 156 (6): 1245-9.

PurposeRecent high-tech innovations in digital surgical technology have led to advances in three-dimensional (3D) and high-definition (HD) operating scopes. We introduce a novel 3D-HD flexible surgical scope called "3D-Eye-Flex" and evaluate its utility as an alternative to the operating microscope.MethodsThe 3D-Eye-Flex has a 15 mm long 3D-HD scope-head with a 15 mm outer diameter, a focus distance of 18-100 mm and 80° angle of view. Attached to a 615-mm-long flexible bellows, 3D-Eye-Flex can be easily fixed to the operating table. Microsurgical dissection of wet brain tissue and drilling a skull base model were performed under the scope while using the 3D-HD video monitor.ResultsThis scope system provided excellent illumination and image quality during the procedures. A large depth of field with stereoscopic vision had a greater advantage over using an operating microscope. 3D-Eye-Flex was easy to manipulate and provided an abundance of space above the operative field. Surgeons felt comfortable while working and could easily shift the position of the scope.ConclusionThis novel 3D-HD flexible scope is an effective alternative to the operating microscope as a new surgeon's eye and will be suitable for digital image-based surgery with further refinement.

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