"With the most critical work being done on the brain for aneurysms, it's very important to understand what's happening inside the vessel, even though you can't see there," Brunner says. "Up until now, you had to wait until after a patient's procedures were finished to check. That's critical for the brain, because if you have a brain with no oxygen for four minutes, it dies. This vascular fluorescence module allows you to see the blood flow in the vessel intraoperatively. It's been a tremendous breakthrough and very popular among vascular surgeons."

Dr. Robert Spetzler, one of the country's leading neurosurgeons, heading up Phoenix's Barrow Neurosurgical Associates. For him, Zeiss is the microscope of choice. Spetzler says one of his favorite features with the Zeiss microscopes is the addition of ICG angiography, which is now incorporated into Zeiss' OPMI Pentero scope.


"This allows exquisite visualization of flow in the blood vessels through the scope using laser induced excitation of the dye and recorded with a special video camera," Spetzler says. "This incredible addition to our armamentarium has decreased the use of regular intraoperative angiography by 85 percent. It is hard to overemphasize the importance of this addition since regular angiography is not only very time consuming, but also has an unassociated risk."

For fluorescence-based tumor resection, Zeiss has introduced the Blue 400, a second fluorescence technology that is an important indicator that delivers a suitable basis for deciding on the extent of tumor removal.

Although the module is available in the U.S., Brunner explains that there is an additional dye that shows fluorescence through the microscope in the tumor but not in the unaffected brain tissue. This allows more complete tumor resection while avoiding the normal brain tissue. The dye is currently approved in Europe but is just now being investigated in the U.S.

Illuminating advances

LED lighting is one of the newest innovations in surgical microscopes, and Leica Microsystems has already begun utilizing LED technology on some of its surgical microscopes.

"We have two new surgical clinic microscopes, Leica M320 F12 for ENT and the Leica M220 F12 for ophthalmology that feature LED lighting. What's important about LED lighting is that it's better for the environment, it's a cool light, and it has a very long lifespan. For the surgeon who purchases a microscope with LED illumination today, his or her grandchildren will be changing the bulbs," Schwartz says. "LED illumination is an area that is expected to grow in other market segments as well."

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