Significance: Surgical microscopes provide adjustable magnification, bright illumination, and clear visualization of the surgical field and have been increasingly used in operating rooms. State-of-the-art surgical microscopes are integrated with various imaging modalities, such as optical coherence tomography (OCT), fluorescence imaging, and augmented reality (AR) for image-guided surgery. Aim: This comprehensive review is based on the literature of over 500 papers that cover the technology development and applications of surgical microscopy over the past century. The aim of this review is threefold: (i) providing a comprehensive technical overview of surgical microscopes, (ii) providing critical references for microscope selection and system development, and (iii) providing an overview of various medical applications. Approach: More than 500 references were collected and reviewed. A timeline of important milestones during the evolution of surgical microscope is provided in this study. An in-depth technical overview of the optical system, mechanical system, illumination, visualization, and integration with advanced imaging modalities is provided. Various medical applications of surgical microscopes in neurosurgery and spine surgery, ophthalmic surgery, ear-nose-throat (ENT) surgery, endodontics, and plastic and reconstructive surgery are described. Results: Surgical microscopy has been significantly advanced in the technical aspects of high-end optics, bright and shadow-free illumination, stable and flexible mechanical design, and versatile visualization. New imaging modalities, such as hyperspectral imaging, OCT, fluorescence imaging, photoacoustic microscopy, and laser speckle contrast imaging, are being integrated with surgical microscopes. Advanced visualization and AR are being added to surgical microscopes as new features that are changing clinical practices in the operating room. Conclusions: The combination of new imaging technologies and surgical microscopy will enable surgeons to perform challenging procedures and improve surgical outcomes. With advanced visualization and improved ergonomics, the surgical microscope has become a powerful tool in neurosurgery, spinal, ENT, ophthalmic, plastic and reconstructive surgeries.

中文翻译：

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手术显微镜综合回顾：技术发展和医学应用

意义：手术显微镜可提供可调节的放大倍数、明亮的照明和清晰的手术视野，并且越来越多地用于手术室。最先进的手术显微镜与各种成像方式相结合，例如用于图像引导手术的光学相干断层扫描 (OCT)、荧光成像和增强现实 (AR)。目的：这篇综合综述基于 500 多篇论文的文献，这些论文涵盖了过去一个世纪手术显微镜的技术发展和应用。本综述的目的有三个：(i) 提供手术显微镜的全面技术概述，(ii) 为显微镜选择和系统开发提供重要参考，以及 (iii) 提供各种医学应用的概述。方法：收集和审查了 500 多篇参考文献。本研究提供了手术显微镜发展过程中重要里程碑的时间表。提供了对光学系统、机械系统、照明、可视化以及与高级成像模式的集成的深入技术概述。描述了手术显微镜在神经外科和脊柱外科、眼科手术、耳鼻喉 (ENT) 手术、牙髓病学以及整形和重建手术中的各种医学应用。结果：外科显微镜在高端光学、明亮无影照明、稳定灵活的机械设计和多功能可视化等技术方面取得了显着进步。新的成像方式，如高光谱成像、OCT、荧光成像、光声显微镜、和激光散斑对比成像，正在与手术显微镜集成。作为改变手术室临床实践的新功能，高级可视化和 AR 正被添加到手术显微镜中。结论：新成像技术和手术显微镜的结合将使外科医生能够执行具有挑战性的手术并改善手术结果。凭借先进的可视化和改进的人体工程学，手术显微镜已成为神经外科、脊柱、耳鼻喉科、眼科、整形和重建手术的强大工具。新成像技术和手术显微镜的结合将使外科医生能够执行具有挑战性的手术并改善手术结果。凭借先进的可视化和改进的人体工程学，手术显微镜已成为神经外科、脊柱、耳鼻喉科、眼科、整形和重建手术的强大工具。新成像技术和手术显微镜的结合将使外科医生能够执行具有挑战性的手术并改善手术结果。凭借先进的可视化和改进的人体工程学，手术显微镜已成为神经外科、脊柱、耳鼻喉科、眼科、整形和重建手术的强大工具。