Interview with Prof. Dr. med. Veit Rohde – Universitätsmedizin Göttingen
How do you use the Paexo?
In neurosurgery, some of the most complex lesions are located within the posterior cranial fossa and the cervical spine. Among these are the acoustic neurinomas, benign tumors of the vestibular nerve, the tumors and vascular lesions in the cerebellum and the fourth ventricle, meningiomas that arise from the posterior base of skull as well as degenerative diseases of the spine. For treating these lesions microsurgically, the patient is brought into a sitting position with the surgeon behind, with the consequence that the neurosurgeon is operating for hours with elevated arms and hands. It is my own experience that the fatigue in the muscles (which inevitably develop over the time) influences the precision of the instrument use, which is required for successful surgery in these highly delicate and narrow operative fields. I use the Paexo, when facing a longer microsurgical operation with the patient in the sitting position.
What was your initial thought on exoskeletons and what are your expectations for your field specifically?
At the beginning, I searched for other solution such as hand-rests mounted to the operating table. However, the use of hand-rests sometimes result in a further limitation of the excess to the surgical field. I searched of a tool, which eliminates the gravity for the arms, and finally found Paexo. I was slightly astonished to hear, that Paexo also belongs to the group of exoskeletons. Up to know, I thought that an exoskeleton is a help for patients with a motor handicap. My expectation is, that the use of Paexo during delicate neurosurgical operations in the sitting position helps me to reduce the fatigue in the arm and hand muscle and allow a constant high surgical precision even in longer surgeries.
How could exoskeletons help surgeons in general and/or specifically in the field of neurosurgery in the future?
The usefulness of an exoskeleton in surgery in general is, in my perspective, linked to positions of the surgeon, which are exhausting over the time of surgery, to positions which are harmful to health if repeated over years, and to activities which require substantial muscle strength. Operating with elevated arms and hands is exhausting, and the first experiences with Paexo are promising. Future studies are necessary to show that the Paexo indeed reduces the muscle strain. For the future, I also can imaging exoskeletons helping to relief the stress on the back during operations with the surgeon standing and exoskeletons which facilitate surgical steps in need for high muscle strength, as often found in spine and orthopedic surgery.