Microsurgical Clipping of an Anterior Communicating Artery Aneurysm Using a Novel Robotic Visualization Tool in Lieu of the Binocular Operating Microscope: Operative Video.

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Publication Date


Publication Title

Oper Neurosurg (Hagerstown)


Aneurysm clipping; BrightMatter; Cerebral aneurysm; Operative video; Robotic arm; Surgical clipping; Surgical exoscope; Surgical technology; Synaptive anterior communicating artery


INTRODUCTION: The binocular operating microscope has been the visualization instrument of choice for microsurgical clipping of intracranial aneurysms for many decades.

OBJECTIVE: To discuss recent technological advances that have provided novel visualization tools, which may prove to be superior to the binocular operating microscope in many regards.

METHODS: We present an operative video and our operative experience with the BrightMatterTM Servo System (Synaptive Medical, Toronto, Ontario, Canada) during the microsurgical clipping of an anterior communicating artery aneurysm. To the best of our knowledge, the use of this device for the microsurgical clipping of an intracranial aneurysm has never been described in the literature.

RESULTS: The BrightMatterTM Servo System (Synaptive Medical) is a surgical exoscope which avoids many of the ergonomic constraints of the binocular operating microscope, but is associated with a steep learning curve. The BrightMatterTM Servo System (Synaptive Medical) is a maneuverable surgical exoscope that is positioned with a directional aiming device and a surgeon-controlled foot pedal. While utilizing this device comes with a steep learning curve typical of any new technology, the BrightMatterTM Servo System (Synaptive Medical) has several advantages over the conventional surgical microscope, which include a relatively unobstructed surgical field, provision of high-definition images, and visualization of difficult angles/trajectories.

CONCLUSION: This device can easily be utilized as a visualization tool for a variety of cranial and spinal procedures in lieu of the binocular operating microscope. We anticipate that this technology will soon become an integral part of the neurosurgeon's armamentarium.

Clinical Institute

Neurosciences (Brain & Spine)