State-of-the-Art Microscope Technology Provides 4K and 3D Visualization Beyond the Surface of the Brain
The Department of Neurosurgery at the Icahn School of Medicine at Mount Sinai is one of the first hospitals in the country to use the ZEISS KINEVO® 900 microscope, a new surgeon-driven, robotic visualization system that merges the functionality of a surgical microscope with 4K resolution and 3D visualization along with specialized robotic control. Optical, navigation, and simulation information are streamed into the microscope’s eyepiece and projected on large monitors in the operating room, providing a detailed perspective for the operating room staff, including co-surgeons, surgical assistants, and medical residents, who can all view the high-resolution images in real time. 3D glasses provide an enhanced visualization of neuroanatomy.
“An important question for neurosurgeons has always been, where is the best place to view optical information from the microscope—should one look through the eyepieces as we’ve done traditionally, or should that information be gathered by high-resolution video and projected on a monitor,” says Joshua Bederson, MD, Professor and System Chair for the Department of Neurosurgery at Mount Sinai Health System and Clinical Director of the Neurosurgery Simulation Core.
Dr. Bederson says one advantage to projecting real-time images of the brain onto a video screen is that information sources from outside the microscope can be overlaid on the monitor. This augmented reality includes navigational guidance that alerts the surgeon to “no-fly zones”—neuroanatomy that should be avoided during surgery. The KINEVO® 900 utilizes an open interface that allows for integration with navigation and image-guided software developed by the medical technology companies Brainlab and Surgical Theater.
“The analogy is the heads-up-display that aircraft pilots have when they’re looking at navigation information during flight,” said Dr. Bederson, a licensed pilot. “The operating room of the future is one that integrates multiple information sources streamed into the surgeon’s viewpoint in a way that is non-distracting and can be used in the service of patient safety.”
KINEVO® 900 has several features that are the first of their kind, including a specialized robotic control system called PointLock, which enables the surgeon to focus on a particular point in the surgical field and move the microscope in a spherical arch without losing focus, with the use of a foot pedal. This allows the surgeon to navigate safely around the patient during surgery as opposed to repositioning the patient. PositionMemory stores magnification and focus settings for key regions of the brain. A micro-inspection surgical tool called QEVO® is engineered with an angled design, allowing the surgeon to look around complex structures that are out of the microscope’s range.
“Our team of neurosurgeons is driving and advancing the development of next-generation simulation and virtual reality technology, which can help improve patient outcomes and solve neurosurgical challenges,” says Dr. Bederson.
The Icahn School of Medicine at Mount Sinai purchased the two robotic visualization systems with the generous support of a donor who wishes to remain anonymous. Dr. Bederson is an expert in skull-base and cerebrovascular surgery and has performed more than 3,700neurosurgical operations at Mount Sinai. Dr. Bederson owns equity in Surgical Theater, LLC.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 18 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Gastroenterology/GI Surgery, Geriatrics, Nephrology, and Neurology/Neurosurgery, and in the top 50 in six other specialties in the 2018-2019 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 11th nationally for Ophthalmology and 44th for Ear, Nose, and Throat. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and South Nassau Communities Hospital are ranked regionally.