The ORBEYE 4K 3D Orbital Camera System
Amongst the marketed exoscopic devices, the ORBEYE 4K 3D platform (Sony Olympus Medical Solutions, Tokyo, Japan; FDA approved) is characterized by one of the highest magnification powers (26X with the 55” screen) keeping a full size 4K image resolution along the whole range of available enlargements. Furthermore, the motorized supporting arm makes its movements easy and accurate and the inclusion of the Narrow Band Imaging tool, developed in the gastroenterological setting and already widely used in the upper aerodigestive tract,3 permits a live intraoperative control of the margins dealing with oncologic resections. During the COVID-19 pandemic, the main advantage of such device is the possibility to avoid the removal of PPE as goggles and face shields approaching microsurgical procedures, with no decreased quality of vision or depth perception if compared with the traditional settings.
Our experience is derived by a case series of twelve successfully treated patients enrolled in September 2019: three tonsillectomies (Figure 1A-C ), three laryngeal tumors transoral laser resections (Figure 1D-F ), one parapharyngeal tumor transoral resection (Figure 1G-I ), three glottic phonomicrosurgical procedures (Figure 1J-K ) and two free flaps harvesting with microvascular anastomosis (Figure 1L ).
In the context of pharyngo-laryngeal oncologic transoral procedures, the ORBEYE 4K 3D guarantees a clear view especially for tumors of the tonsillar area or lateral oropharyngeal wall, with no need of angled telescopes coupled to the camera. Moreover, by means of ORBEYE 4K 3D and a Tulium-diode fiber laser as cutting device, both an excellent cutting and coagulation power are ensured, being possible to achieve very accurate resections with a minimally invasive approach.
The high magnification power with 4k resolution also allows the execution of microsurgical vascular anastomosis for free flaps reconstructions, suggesting its easy application as system of vision, as already tested also by other authors, in several microsurgical fields as otoneurosurgery,4 reconstructive surgery,5 ophthalmology or neurosurgery.6 Furthermore, its excellent lighting and image definition features permit a clear view also in the narrow corridor of a laryngoscope, ensuring precise phonomicrosurgical procedures, also with a better ergonomics; this suggests, in centers already equipped with this technology, a benefit also for elective transoral procedures after the end of the COVID-19 pandemic.