Use of the 4K-3D ORBEYE Exoscope for Supermicrosurgical Lymphaticovenular Anastomosis: A Case Report.

The evolution in microsurgery using high-definition three-dimensional (3D) cameras has provided the opportunity to replace conventional operating microscopes (OM), improving ergonomics for microsurgeons. Several 3D exoscope systems have already demonstrated good surgical field visualization in a 3D space in performing microvascular anastomosis with favorable maneuverability and non-inferiority compared to OM. We present the application of the 4K-3D ORBEYE system (Olympus Inc., Tokyo, Japan) in performing lymphaticovenular anastomosis to treat lower limb lymphedema and the challenges and tips to manage small vessels measuring <0.8 mm. This system provided a good intraoperative outcome with greater ergonomics and a non-inferiority magnification compared to traditional microscopes. Our findings need further studies to confirm the feasibility; however, the 4K-3D ORBEYE represents a valid possibility to assist microsurgeons in lymphatic surgery.