• Takuya Nakamura, Toshihiro Ogiwara, Tetsuya Goto, Yu Fujii, Yoshinari Miyaoka, Yoshiki Hanaoka, Tetsuyoshi Horiuchi, and Kazuhiro Hongo.
• Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan.
• World Neurosurg. 2020 Feb 1; 134: 293-296.

BackgroundWhen medical devices and equipment in an operating room are connected to a network, vast amounts of data concerning the progress of the operation and the patient's condition can be comprehensively processed to improve the precision and safety of the surgical procedure. To make this possible, a next-generation networked operating room, "Smart Cyber Operating Theater" (SCOT), has been developed with medical-engineer cooperation. SCOT integrates stand-alone medical devices using the "OPeLiNK" communication interface. Using OPeLiNK, medical devices are connected and various data, such as intraoperative magnetic resonance imaging, neuromonitoring, biochemical monitoring, and navigation system, are integrated and displayed in the same timeline.Case DescriptionThe authors succeeded in clinical tumor resection via the endoscopic endonasal approach using the SCOT system in a 79-year-old man with a large nonfunctioning pituitary adenoma. The surgeons performed the operation while sharing information in real time between all staff in the operating room and supervising expert surgeons at the surgical strategy desk. Any decisions, such as intraoperative surgical procedures, were made with discussion between the operating room and the surgical strategy desk. The patient's postoperative course was uneventful.ConclusionsThis is the first case report of endoscopic endonasal approach performed successfully in the SCOT. Further developments in this technology may lead to innovations in not only microscopic neurosurgery but also endoscopic neurosurgery.Copyright © 2019 Elsevier Inc. All rights reserved.

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