Miller School Performs First-Ever Male Fertility Microsurgery Using Innovative Imaging Tool

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A new imaging tool has the potential to transform microsurgical procedures for many specialties, including male fertility surgery. Ranjith Ramasamy, M.D., director of male reproductive medicine and surgery and assistant professor of urology at the University of Miami Miller School of Medicine, and his team performed the first-ever male infertility microsurgery in Florida using the ORBEYE, a 4K-3D video microscope. So far, they have used the tool for more than 15 fertility microsurgeries ranging from vasectomy reversals to microsurgical varicelectomy.

ORBEYE video microscope, courtesy of Olympus.

Performing surgery on the testicles and other organs of the reproductive system has always posed challenges. “The structures of the spermatic cord and within the testicles are very small,” said Dr. Ramasamy. “In the past, that required a fixed microscope to provide the level of magnification required for the procedure.”

While a traditional microscope made it easy to see while performing fertility microsurgery, it’s not designed to move around. That meant that both the large, unwieldy microscope and the patient had to remain in a fixed position throughout the procedure. “Some have advocated for a robot to address this challenge, but they traditionally have only provided 10x magnification,” said Dr. Ramasamy. “A microscope provides 25x magnification.”

The ORBEYE is an advanced digital video microscope that combines the agility and mobility of a robot with the magnification of a microscope. The camera provides the highest resolution, 3D imagery at the end of a fully mobile robotic arm. It also can zoom to up to 26x magnification, as needed, for specific procedures. As a microsurgical team works, all of this is displayed on a large 4K monitor for easy observation.

“Overall, the operative times using the ORBEYE are shorter, which means the patient’s recovery time is faster, and he gets to go home sooner,” Dr. Ramasamy said.

The ORBEYE is a relatively new medical tool, but the early published research on the device appears positive. A recent article in the journal Clinical Neurology and Neurosurgery evaluated its use in 14 different microneurosurgeries, which are surgeries using extreme magnification to see tiny structures in the body.

Overall, the device scored high and was well-liked by the neurosurgeons who used it. In particular, the compact size, mobility and the freedom from having to squint through a microscope lens were all highly rated characteristics of the tool. In addition, neurosurgeons tended to like the device even more when they performed additional procedures with it.