• Oreste De Divitiis, Elena D'avella, Luca Denaro, Teresa Somma, Matteo Sacco, and Domenico D'avella.
• Department of Neurosurgery, Università degli Studi di Napoli "Federico II", Naples, Italy - oreste.dedivitiis@unina.it.
• J Neurosurg Sci. 2019 Apr 2.

BackgroundIn the last decade, application of the high-definition exoscope to different neurosurgical procedures has been reported in the literature. We describe the first experience with the VITOM®-3D for the surgical treatment of intradural extra-medullary tumors.MethodsFive neurosurgical procedures for the removal of intradural extra-medullary tumors were performed with the VITOM®-3D. Patients' population, feasibility of surgery under the exoscope visualization, VITOM®-3D's technical and optical characteristics, and surgical outcome were analyzed.ResultsAll surgeries were performed following the common steps of spinal neurosurgical intradural procedures. The exoscope offered excellent, magnified and brilliantly illuminated high definition images of the surgical field in all the described cases. All the reported surgical operations were successfully completed under exoscope magnification from both the technical as well as the clinical points of view. No complications potentially related to the use of the exoscope occurred. Working environment ergonomics and trainees learning experience were the most relevant benefits associated with the use of exoscope.ConclusionsVITOM®-3D may represent a valid visualization tool in spinal procedure for intradural extra-medullary tumors. Our preliminary experience can be useful in better define the role of VITOM®-3D in neurosurgery.

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