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New Microscope at Barrow Enables More Efficient Neurosurgery

Zeiss selected Barrow as the development site for its latest neurosurgical microscope, allowing Barrow neurosurgeons to be among the first to use the Kinevo 900.

The German manufacturer says the microscope enables neurosurgeons to work more efficiently, reduce manual hassles, and eliminate blind spots in surgery through robotics, digital visualization, and an integrated micro-inspection tool.

“It’s a transformative upgrade on the whole microscope from the previous model,” said Dr. Michael Lawton, president and CEO of Barrow. “We are committed to being state-of-the-art in all that we do. With 11 of the previous model in every operating room, we will soon be upgrading our entire fleet of microscopes to continue to apply the latest and best technology to our craft.”

Robotics: More Precision in Less Time

Kinevo’s robotic system lets neurosurgeons automate the microscope’s position based on their pre-operative planning. With the push of a button, the microscope can move to a precise, predetermined location, which can save time when approaching aneurysms, tumors, and other deep abnormalities in the brain.

“It goes from a microscope on a counterbalanced stand that floats freely in the field, to one that can also be driven by robotics,” Dr. Lawton said. “There are motors and sensors in the stand that allow the microscope to drive itself to specific coordinates.”

In fact, the robotic system can remember and return to a precise location at the exact same magnification, working distance, and focus as previously viewed. The neurosurgeon can also lock the microscope in place and swivel it for other perspectives without having to reposition the entire microscope. This means less effort for the surgeon and fewer disruptive vibrations.

Micro-Inspection Tool Increases Surgical Certainty

Perhaps the most beneficial feature of the Kinevo 900 is the QEVO micro-inspection tool. This handheld micro-inspection tool allows the neurosurgeon to explore areas that cannot be seen from overhead without removing more bone or retracting more tissue.

“That tool can help you do safer surgery,” Dr. Lawton said. “If you’ve missed a little piece of tumor or a little piece of malformation hiding in a blind corner, you can stick QEVO in, look around, and identify these remaining pieces while you’re in there, rather than on the postoperative scans when it’s too late to correct. That will have a direct patient impact.”

QEVO is similar to an endoscope—an instrument with a tiny camera and light that allows surgeons to look deep inside the body. But Dr. Lawton noted a key difference.

“It’s always been awkward to transition to an endoscope setup with different equipment and different screens,” Dr. Lawton said. “QEVO is all integrated with the microscope, so you can easily add perspectives on your pathology and your surgical corridor.”

The neurosurgeon can simply plug the tool into the microscope at any time and seamlessly switch between the two views.

QEVO is also engineered with an angled design to keep the surgeon’s hands out of the line of sight. The entire tool can be placed in an autoclave and steam sterilized, which eliminates the need for draping.

‘Heads-up’ Display: The Future of Neurosurgery?

Another feature of the Kinevo 900 is its digital visualization, which provides the neurosurgeon with more freedom of movement.

“It’s got what we call a ‘heads-up’ display, which means you can aim it like a camera over the field and instead of viewing it through eyepieces, you can view it on a big screen that has high resolution,” Dr. Lawton said.

This could reduce the fatigue and discomfort that come with being tied to a microscope. However, the surgeon still has the option to use the optical setup, which is still necessary for procedures in which the surgeon is dependent on depth perception.

Dr. Lawton expects the future of digital visualization to include augmented reality, allowing neurosurgeons to better visualize trajectory lines, tumor borders, and anatomy.

“That way you can see what’s not there,” he said. “It’s like when you watch a football game and you have the first down markers on the field.”

“We see this field moving quickly in uncertain directions,” he added. “We want to be positioned to define these directions. We want to lead the way.”

About Barrow

Since our doors opened as a regional specialty center in 1962, we have grown into one of the premier destinations in the world for neurology and neurosurgery. Our experienced, highly skilled, and comprehensive team of neurological specialists can provide you with a complete spectrum of care–from diagnosis through outpatient neurorehabilitation–under one roof. Barrow Neurological Institute: Discover. Educate. Heal.