• Jose Luis Acha, Luis Contreras, Keneth Lopez, Miguel Azurin, Manuel Cueva, Adriana Bellido, Shamir Contreras, and Oscar Santos.
• Vascular Neurosurgery and Skull Base Service of the Dos de Mayo National Hospital, Lima, Peru; National University of San Marcos, Lima, Peru. Electronic address: jacha@crp.com.pe.
• World Neurosurg. 2023 Jun 1; 174: 636863-68.

BackgroundThe microscope is important in neurosurgery, but it is not exempt from limitations. The exoscope has emerged as an alternative because it offers better 3-dimensional (3D) visualization and better ergonomics. We present our initial experience in vascular pathology using 3D exoscopy at the Dos de Mayo National Hospital to show the viability of the 3D exoscope in vascular microsurgery. We also provide a review of the literature.MethodsIn this work, the Kinevo 900 exoscope was used in 3 patients with cerebral (2) and spinal (1) vascular pathology. We evaluated the image quality, equipment management, ergonomics, educational utility, and 3D glasses and recorded the characteristics of the cases. We reviewed the experience of other authors as well.ResultsThree patients underwent surgery: 1 occipital cavernoma, 1 cerebral dural fistula, and 1 spinal dural fistula. Excellent 3D visualization with Zeiss Kinevo 900 exoscope (Carl Zeiss, Germany), surgical comfort, and educational utility occurred, and there were no complications.ConclusionsOur experience and that of other authors suggests that the 3D exoscope shows excellent visualization, better ergonomics, and an innovative educational experience. Vascular microsurgery can be performed safely and effectively.Copyright © 2023 Elsevier Inc. All rights reserved.

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