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Online First

10.4103/aja.aja_94_20

3D digital image microscope system-assisted vasovasostomy and vasoepididymostomy in rats

Peng Li1, Na-Chuan Liu1, Er-Lei Zhi1, Chen-Cheng Yao1, Zhi-Liang Zhao2, Zhi-Yong Yu3, Qi-Meng Li4, Yu-Hua Huang1, Jie-Chang Ju5, Wen-Bin Huang6, Husanjan Rozi7, Zhi-Yong Ji8, San-Wei Guo9, Ru-Hui Tian1, Zheng Li1

1 Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
2 Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
3 Weifang Traditional Chinese Hospital, Weifang 250200, China
4 The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
5 Zhengzhou Central Hospital Affiliated with Zhengzhou University, Zhengzhou 450007, China
6 Wenzhou Integrated Traditional Chinese, Wenzhou 325000, China
7 Kashgar District Second People's Hospital, Kashgar 844000, China
8 Shanghai General Hospital of Nanjing Medical University, Shanghai 200080, China
9 Shanghai Tenth People's Hospital, Tongji University, Shanghai 200072, China

Correspondence: Dr. Z Li (lizhengboshi@163.com)

09-Feb-2021

Abstract

Optimal vision and ergonomics are essential factors contributing to the achievement of good results during microsurgery. The three-dimensional (3D) digital image microscope system with a better 3D depth of field can release strain on the surgeon's neck and back, which can improve outcomes in microsurgery. We report a randomized prospective study of vasoepididymostomy and vasovasostomy using a 3D digital image microscope system (3D-DIM) in rats. A total of 16 adult male rats were randomly divided into two groups of 8 each: the standard operating microscope (SOM) group and the 3D-DIM group. The outcomes measured included the operative time, real-time postoperative mechanical patency, and anastomosis leakage. Furthermore, a user-friendly microscope score was designed to evaluate the ergonomic design and equipment characteristics of the microscope. There were no differences in operative time between the two groups. The real-time postoperative mechanical patency rates were 100.0% for both groups. The percentage of vasoepididymostomy anastomosis leakage was 16.7% in the SOM group and 25.0% in the 3D-DIM group; however, no vasovasostomy anastomosis leakage was found in either group. In terms of the ergonomic design, the 3D-DIM group obtained better scores based on the surgeon's feelings; in terms of the equipment characteristics, the 3D-DIM group had lower scores for clarity and higher scores for flexibility and adaptivity. Based on our randomized prospective study in a rat model, we believe that the 3D-DIM can improve surgeon comfort without compromising outcomes in male infertility reconstructive microsurgery, so the 3D-DIM might be widely used in the future.

Keywords: microsurgery; three-dimensional digital image microscope system; vasoepididymostomy; vasovasostomy

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