Immersive 3D Technology Enhances Neurosurgical Outcomes at Penn State Health Milton S. Hershey Medical Center

By Jenna Haines
Tuesday, June 11, 2019
Specialty: 

A newly incorporated, cutting-edge visualization tool is improving the precision of brain and spinal surgeries at Penn State Health Milton S. Hershey Medical Center.


Brad E. Zacharia, MD, MS, assistant professor of neurosurgery and director of neuro-oncology and skull base surgery in the Department of Neurosurgery at Penn State College of Medicine and co-director of neuro-oncology at Penn State Hershey Cancer Institute, examines a patient case in one of the neurosurgical operating rooms at Penn State Health Milton S. Hershey Medical Center. These recently added or upgraded rooms provide surgeons with cutting-edge technology for optimal visualization of the brain and spine structures before, during and after operations. Penn State Health’s use of lasers, robotics and radiosurgery provides minimally invasive neurosurgical options for patients.

In January, the Milton S. Hershey Medical Center became the first program in Pennsylvania and one of the first five centers in the U.S. to perform surgery with the assistance of the Olympus ORBEYE.

The ORBEYE is a compact, flexible exoscope, or video microscope, that captures and magnifies real-time, 3D video of the operating field on multiple large screens in stunning 4K resolution. This provides the surgeon and other members of the surgical team, including nurses, scrub technicians and anesthesiologists, an unobstructed line of sight.

The ORBEYE is quickly supplanting the role of the conventional surgical microscope in neurosurgical procedures at Hershey Medical Center, according to Brad E. Zacharia, MD, MS, assistant professor of neurosurgery and director of neuro-oncology and skull base surgery in the Department of Neurosurgery at Penn State College of Medicine and co-director of neuro-oncology at Penn State Hershey Cancer Institute.

“Up to 50 percent of the brain and spinal surgeries we perform have traditionally required the increased magnification of a microscope, a tool that has been used in neurosurgery for the greater part of the past century,” Dr. Zacharia says. “Due to the ease and effectiveness of this new technology, however, we now use the ORBEYE for all of these operations and even in some additional cases in which the use of a conventional microscope would not have been beneficial.”

“The Olympus ORBEYE is an example of Penn State Health’s demonstrated commitment to improving patient safety and outcomes. From an institutional standpoint, this investment in technology and in the physicians and staff with the necessary expertise to take full advantage of its capabilities allows us to be on the leading edge of patient care.”
— Brad E. Zacharia, MD, MS, assistant professor of neurosurgery and director of neuro-oncology and skull base surgery in the Department of Neurosurgery at Penn State College of Medicine and co-director of neuro-oncology at Penn State Hershey Cancer Institute

A Boon to Patients and Surgeons

One of the most tangible benefits of the ORBEYE, Dr. Zacharia says, is its remarkable resolution and 3D capabilities.

“It provides an extraordinarily clear and crisp image with a much broader depth of field than a traditional microscope,” he explains. “This helps us differentiate important tissues when removing tumors or performing other critical microsurgical operations.”

Having detailed images of the operation projected onto large screens also provides an important ergonomic advantage for the surgeon, which in turn benefits patients.

“Many operations would ordinarily force us to contort our heads and bodies in awkward ways,” Dr. Zacharia says. “Over the length of a six- to 12-hour procedure, that can really wear on the body. By providing greater comfort to the surgeons, the use of the ORBEYE translates to our being able to do a safer, more effective job at removing a brain tumor, for example, and performing surgery in an extremely delicate area. Any technology that affords us the ability to not get fatigued and to be steadier and more comfortable for long periods of time ultimately improves patient care, outcomes and safety. It also potentially extends the duration of a surgeon’s career, as fatigue can make it more difficult to perform complex operations over time.”

Another significant benefit of the ORBEYE over conventional microscopes is that it immerses all members of the surgical team in the operation by permitting an unobstructed, real-time view of each detail of the procedure.

“After the surgeon completes the initial approach with the assistance of surgical loupes, everyone in the operating theater puts on a pair of 3D glasses, the lights in the room are dimmed, and the operating field is projected onto multiple screens,” Dr. Zacharia says. “The anesthesiologist may be looking one way, and I may be looking another, but everyone can see what is happening on the screen. This results in a dramatic improvement in the clinical team’s ability to fully and directly engage and participate in the procedure, which increases staff satisfaction and, again, improves outcomes and safety for our patients.”

The Future Is 3D

As of April, Hershey Medical Center had performed more than 50 brain and spinal surgeries using the ORBEYE — over 30 of which were performed by Dr. Zacharia himself.

“We’re in the early stages of seeing these devices really come to fruition,” he says. “We have used exoscopes at Hershey Medical Center for some time. However, the optics of past exoscopes have traditionally been two-dimensional. For more technically complex procedures, we need that three-dimensional depth, so I only see this technology gaining traction from here. It is easy to use, takes up minimal space and provides ancillary benefits that set it apart from anything else on the market. Nothing quite puts the pieces together like the ORBEYE.”


For more information, visit hmc.pennstatehealth.org/neurosurgery or call 717-531-3828.