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de Divitiis et al. Mini-invasive Surg 2020;4:75 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.66

Review Open Access

The role of Vitom-3D in the management of spinal
meningiomas: review of the literature and illustrative

case

Oreste de Divitiis , Elena d’Avella , Matteo Sacco , Teresa Somma , Mehmet Turgut , Valentina Baro , Luca
2
1
1
1
1
3
Denaro 3
1 Department of Neurosurgery, Università degli Studi di Napoli “Federico II”, Naples 80131, Italy.
2 Department of Neurosurgery, Adnan Menderes University School of Medicine, Aydın 09100, Turkey.
3 Department of Neurosurgery, University of Padua, Padua 35128, Italy.
Correspondence to: Dr. Elena d’Avella, Department of Neurosciences and Reproductive and Odontostomatological Sciences,
Division of Neurosurgery, University of Napoli “Federico II”, Via Pansini 5, Naples 80131, Italy. E-mail: elenadavella@gmail.com
How to cite this article: de Divitiis O, d’Avella E, Sacco M, Somma T, Turgut M, Baro V, Denaro L. The role of Vitom-3D in the
management of spinal meningiomas: review of the literature and illustrative case. Mini-invasive Surg 2020;4:75.
http://dx.doi.org/10.20517/2574-1225.2020.66

Received: 30 Jun 2020 First Decision: 4 Sep 2020 Revised: 18 Sep 2020 Accepted: 24 Sep 2020 Published: 6 Nov 2020
Academic Editor: Giulio Belli Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
The favorable outcome generally associated with spinal meningioma surgery is the result of the continuing
refinement of the surgical technique, the use of intraoperative neuromonitoring, and a better understanding of
the tumor biological behavior. Among all the technological advancements, visualization tools are the keys to any
successful surgical procedure. The operating microscope is the gold standard in all neurosurgical procedures.
In recent years, high-definition exoscope systems have entered the field of neurosurgery, as another tool in the
armamentarium of the contemporary neurosurgeon. After initial experiences and technical improvements, the
exoscope has proven to be best suited for spinal procedures. This study aims to briefly review the exoscope
journey in neurosurgery, with a special focus on spinal meningioma surgery. Benefits and limitations are analyzed
and an illustrative case is reported. Spinal meningiomas removal under exoscope visualization has proven to
be feasible, efficient, and safe. Indication for the use of the exoscope greatly depends on meningioma size,
consistency, relationship to surrounding neurovascular structures, and the surgeon’s experience. Switching to the
operating microscope, if deemed safer, should always be considered.

Keywords: Ergonomics, exoscope, feasible, illumination, magnification, safe, teaching

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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