Hand Position Research Articles

Heightened interoception in adults with fibromyalgia

Previous research suggests that the processing of internal body sensations (interoception) affects how we experience pain. Some evidence suggests that people with fibromyalgia syndrome (FMS) – a condition characterised by chronic pain and fatigue – may have altered interoceptive processing. However, extant findings are inconclusive, and some tasks previously used to measure interoception are of questionable validity. Here, we used an alternative measure – the Phase Adjustment Task (PAT) – to examine cardiac interoceptive accuracy in adults with FMS. We examined: (i) the tolerability of the PAT in an FMS sample (N = 154); (ii) if there are differences in facets of interoception (PAT performance, PAT-related confidence, and scores on the Private Body Consciousness Scale) between an FMS sample and an age- and gender-matched pain-free sample (N = 94); and (iii) if subgroups of participants with FMS are identifiable according to interoceptive accuracy levels. We found the PAT was tolerable in the FMS sample, with additional task breaks and a recommended hand posture. The FMS sample were more likely to be classified as ‘interoceptive’ on the PAT, and had significantly higher self-reported interoception compared to the pain-free sample. Within the FMS sample, we identified a subgroup who demonstrated very strong evidence of being interoceptive, and concurrently had lower fibromyalgia symptom impact (although the effect size was small). Conversely, self-reported interoception was positively correlated with FMS symptom severity and impact. Overall, interoception may be an important factor to consider in understanding and managing FMS symptoms. We recommend future longitudinal work to better understand associations between fluctuating FMS symptoms and interoception.

Hand Grasp Classification in Egocentric Video After Cervical Spinal Cord Injury.

The hand function of individuals with spinal cord injury (SCI) plays a crucial role in their independence and quality of life. Wearable cameras provide an opportunity to analyze hand function in non-clinical environments. Summarizing the video data and documenting dominant hand grasps and their usage frequency would allow clinicians to quickly and precisely analyze hand function. We introduce a new hierarchical model to summarize the grasping strategies of individuals with SCI at home. The first level classifies hand-object interaction using hand-object contact estimation. We developed a new deep model in the second level by incorporating hand postures and hand-object contact points using contextual information. In the first hierarchical level, a mean of 86% ±1.0% was achieved among 17 participants. At the grasp classification level, the mean average accuracy was 66.2 ±12.9%. The grasp classifier's performance was highly dependent on the participants, with accuracy varying from 41% to 78%. The highest grasp classification accuracy was obtained for the model with smoothed grasp classification, using a ResNet50 backbone architecture for the contextual head and a temporal pose head. We introduce a novel algorithm that, for the first time, enables clinicians to analyze the quantity and type of hand movements in individuals with spinal cord injury at home. The algorithm can find applications in other research fields, including robotics, and most neurological diseases that affect hand function, notably, stroke and Parkinson's.

More With Less: Single-Incision Sling Insertion Techniques

To demonstrate reproducible procedures for efficient single-incision sling insertion and troubleshooting. Narrated video footage with stepwise demonstration of single-incision sling insertion technique with anchor system. The mesh midurethral sling is a highly effective and safe procedure that is considered the gold standard for surgical treatment of stress urinary incontinence. Retropubic and transobturator approaches for midurethral slings have similar subjective cure rates with differing surgical risk profiles [1,2]. The retropubic route has a higher risk of injury to the bladder, nerves, and vascular structures, whereas the obturator approach carries a risk of groin or thigh pain [3-5]. Use of a single-incision sling decreases these risks and allows flexibility to perform the procedure without sedation or general anesthesia. Recent literature demonstrates similar subjective and objective success and safety of single-incision slings compared with both retropubic and transobturator approaches, although long-term data are forthcoming [5]. We demonstrate a stepwise approach for the insertion of a single-incision sling using a helical trocar. Easily reproducible procedures for setup and sling anchor management allow for efficient placement without assistance. In addition, we outline hand positioning, trocar management, and anchor deployment with troubleshooting techniques for potential placement difficulties. Finally, we review methods for sling tensioning to prevent complications such as voiding dysfunction and mesh or suture exposures. Given that single-incision slings are more likely to be performed under local anesthesia and are less invasive with decreased recovery time, it has the potential to become the preferred approach in the future. This video demonstrates clear and detailed steps to facilitate successful placement of the single-incision mesh midurethral sling.

Designing a 3D gestural interface to support user interaction with time-oriented data as immersive 3D radar charts

The design of intuitive three-dimensional user interfaces is vital for interaction in virtual reality, allowing to effectively close the loop between a human user and the virtual environment. The utilization of 3D gestural input allows for useful hand interaction with virtual content by directly grasping visible objects, or through invisible gestural commands that are associated with corresponding features in the immersive 3D space. The design of such interfaces remains complex and challenging. In this article, we present a design approach for a three-dimensional user interface using 3D gestural input with the aim to facilitate user interaction within the context of Immersive Analytics. Based on a scenario of exploring time-oriented data in immersive virtual reality using 3D Radar Charts, we implemented a rich set of features that is closely aligned with relevant 3D interaction techniques, data analysis tasks, and aspects of hand posture comfort. We conducted an empirical evaluation (n=12)\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$(n=12)$$\\end{document}, featuring a series of representative tasks to evaluate the developed user interface design prototype. The results, based on questionnaires, observations, and interviews, indicate good usability and an engaging user experience. We are able to reflect on the implemented hand-based grasping and gestural command techniques, identifying aspects for improvement in regard to hand detection and precision as well as emphasizing a prototype’s ability to infer user intent for better prevention of unintentional gestures.

Effectiveness of a dispatcher-assisted CPR using an animated image: Simulation study

IntroductionConsidering the few studies evaluating bystander cardiopulmonary resuscitation (CPR) performance, we sought to analyze differences in bystander CPR performance with and without the use of our self-developed animated GIFs based on dispatcher-assisted CPR simulation. MethodsA total of 80 adults who had not received CPR training over the past two years participated in the study. Among them, 40 people were classified into the auditory group (receiving CPR instructions only over the phone), and the other 40 people were classified into the audiovisual group (receiving CPR instructions over the phone after receiving images on a smartphone). All participants were asked to perform adult and infant CPR for 2 min. CPR performance was recorded using two video cameras (front and side) and analyzed by two emergency physicians, whereas CPR quality was measured using Resusci Anne & Baby QCPR Mk II (Laerdal). ResultsIn the adult CPR study, the audiovisual group had higher performance scores for adequacy of “knee position,” “hand posture,” “elbow extension,” and “vertical compression,” as well as higher Standard Posture Completeness and Instruction Performance scores (p < 0.001). No significant difference in CPR quality was observed between the two groups. In the infant CPR study, audiovisual group had higher performance scores in adequacy of “compression site,” “finger posture,” and “vertical compression,” as well as higher Standard Posture Completeness and Instruction Performance scores (p < 0.001). Regarding CPR quality, the audiovisual group had higher scores for “adequate compression rate ratio” (p = 0.047). ConclusionAudiovisual guidance using animated GIFs more effectively improved CPR Standard Posture Completeness and Instruction Performance than did traditional auditory guidance.

Supplementary value and diagnostic performance of computed tomography scout view in the detection of thoracolumbar spine injuries.

Assessing the diagnostic performance and supplementary value of whole-body computed tomography scout view (SV) images in the detection of thoracolumbar spine injuries in early resuscitation phase and identifying frequent image quality confounders. In this retrospective database analysis at a tertiary emergency center, three blinded senior experts independently assessed SV to detect thoracolumbar spine injuries. The findings were categorized according to the AO Spine classification system. Confounders impacting SV image quality were identified. The suspected injury level and severity, along with the confidence level, were indicated. Diagnostic performance was estimated using the caret package in R programming language. We assessed images of 199patients, encompassing 1592 vertebrae (T10-L5), and identified 56 spinal injuries (3.5%). Among the 199 cases, 39 (19.6%) exhibited at least one injury in the thoracolumbar spine, with 12 (6.0%) of them displaying multiple spinal injuries. The pooled sensitivity, specificity, and accuracy were 47%, 99%, and 97%, respectively. All experts correctly identified the most severe injury of AO type C. The most common image confounders were medical equipment (44.6%), hand position (37.6%), and bowel gas (37.5%). SV examination holds potential as a valuable supplementary tool for thoracolumbar spinal injury detection when CT reconstructions are not yet available. Our data show high specificity and accuracy but moderate sensitivity. While not sufficient for standalone screening, reviewing SV images expedites spinal screening in mass casualty incidents. Addressing modifiable factors like medical equipment or hand positioning can enhance SV image quality and assessment.

Simultaneous Estimation of Digit Tip Forces and Hand Postures in a Simulated Real-Life Condition With High-Density Electromyography and Deep Learning.

In myoelectric control, continuous estimation of multiple degrees of freedom has an important role. Most studies have focused on estimating discrete postures or forces of the human hand but for a practical prosthetic system, both should be considered. In daily life activities, hand postures vary for grasping different objects and the amount of force exerted on each fingertip depends on the shape and weight of the object. This study aims to investigate the feasibility of continuous estimation of multiple degrees of freedom. We proposed a reach and grasp framework to study both absolute fingertip forces and hand movement types using deep learning techniques applied to high-density surface electromyography (HD-sEMG). Four daily life grasp types were examined and absolute fingertip forces were simultaneously estimated while grasping various objects, along with the grasp types. We showed that combining a 3-dimensional Convolutional Neural Network (3DCNN) with a Long Short-term Memory (LSTM) can reliably and continuously estimate the digit tip forces and classify different hand postures in human individuals. The mean absolute error (MAE) and Pearson correlation coefficient (PCC) results of the force estimation problem across all fingers and subjects were 0.46 ± 0.23 and 0.90 ± 0.03% respectively and for the classification problem, they were 0.04 ± 0.01 and 0.97 ± 0.02%. The results demonstrated that both absolute digit tip forces and hand postures can be successfully estimated through deep learning and HD-sEMG.

Softness Perception of Visual Objects Controlled by Touchless Inputs: The Role of Effective Distance of Hand Movements.

Feedback on the material properties of a visual object is essential in enhancing the users' perceptual experience of the object when users control the object with touchless inputs. Focusing on the softness perception of the object, we examined how the effective distance of hand movements influenced the degree of the object's softness perceived by users. In the experiments, participants moved their right hand in front of a camera which tracked their hand position. A textured 2D or 3D object on display deformed depending on the participant's hand position. In addition to establishing a ratio of deformation magnitude to the distance of hand movements, we altered the effective distance of hand movement, within which the hand movement could deform the object. Participants rated the strength of perceived softness (Experiments 1 and 2) and other perceptual impressions (Experiment 3). A longer effective distance produced a softer impression of the 2D and 3D objects. The saturation speed of object deformation due to the effective distance was not a critical determinant. The effective distance also modulated other perceptual impressions than softness. The role of the effective distance of hand movements on perceptual impressions of objects under touchless control is discussed.

Validity and Impact of Methods for Collecting Training Data for Myoelectric Prosthetic Control Algorithms.

Intuitive regression control of prostheses relies on training algorithms to correlate biological recordings to motor intent. The quality of the training dataset is critical to run-time regression performance, but accurately labeling intended hand kinematics after hand amputation is challenging. In this study, we quantified the accuracy and precision of labeling hand kinematics using two common training paradigms: 1) mimic training, where participants mimic predetermined motions of a prosthesis, and 2) mirror training, where participants mirror their contralateral intact hand during synchronized bilateral movements. We first explored this question in healthy non-amputee individuals where the ground-truth kinematics could be readily determined using motion capture. Kinematic data showed that mimic training fails to account for biomechanical coupling and temporal changes in hand posture. Additionally, mirror training exhibited significantly higher accuracy and precision in labeling hand kinematics. These findings suggest that the mirror training approach generates a more faithful, albeit more complex, dataset. Accordingly, mirror training resulted in significantly better offline regression performance when using a large amount of training data and a non-linear neural network. Next, we explored these different training paradigms online, with a cohort of unilateral transradial amputees actively controlling a prosthesis in real-time to complete a functional task. Overall, we found that mirror training resulted in significantly faster task completion speeds and similar subjective workload. These results demonstrate that mirror training can potentially provide more dexterous control through the utilization of task-specific, user-selected training data. Consequently, these findings serve as a valuable guide for the next generation of myoelectric and neuroprostheses leveraging machine learning to provide more dexterous and intuitive control.

Motion shapes for sound shaping.

The focus of this perspective paper is on relationships between sound-producing body motion and corresponding perceived sound features, guided by the idea of shapes as the common denominator of these two domains. The term shape is used to denote graphical-pictorial renderings of phenomena that we perceive or imagine, and may have physical manifestations as tracings on paper or on screen, or as gesticulations, or just as imagined tracings in our minds. Shapes give us intermittent snapshots of unfolding motion and sound fragments, and the point of shapes is to make ephemeral sound and motion features tractable as more permanent objects. Shapes of perceived sound include dynamic, spectral, textural, pitch-related, harmonic, etc. features as shapes, whereas shapes of sound-producing motion include both motion trajectories and postures of sound-producing effectors, i.e., of fingers, hands, arms, etc., or mouth, lips, and tongue.

Signed expressions spotting and recognition in an assistive technology system

An algorithm for processing the continuous stream of incoming video data to detect and recognize signed expressions is proposed. The aim is to improve an assistive technology system. The method is based on the dynamic flow of expression models between a repository of inactive models and pools of active and completed models. When modeling signed expressions, so-called visemes are used. These are units smaller than words - the equivalent of phonemes known from speech recognition. Visemes are extracted by clustering descriptors of the holistic skeletons. The sequential-simultaneous nature of gestures is considered, and the modeling is carried out in four parallel channels related to the position and shape of both hands. The conditions for activation, deactivation, and recognition of the model as completed are formulated, assuming asynchronous changes in individual channels. The method is successfully tested on a demanding dataset recorded by potential users.

Toward safer Human-Robot collaboration in MR environment

This paper presents a Mixed Reality (MR) approach to extend the Safe Move tool from ABB Robot Studio (RS) to view and intuitively edit the safety configuration, allowing the import of existing configurations and the export of modified ones to RS for certification by the expert. The added virtual sensor can detect the user's position allowing collision detection and avoidance. The robot's motion is not only adjusted to the safety zone in which the robot is but also to its relative position to the operator by monitoring in real-time positions of the operator's hands as well as head and triggering appropriate action in the robot.

Prevalence of musculoskeletal pain among undergraduate students.

Musculoskeletal disorders (MSDs) are rapidly rising in Saudi Arabia, reaching levels similar to those in the Western world. Hence, we aimed to assess the prevalence of neck, shoulder, and lower back pains (musculoskeletal pain, MSP) among students at King Khalid University in Abha, Saudi Arabia. This cross-sectional study was conducted at King Khalid University in Abha, Saudi Arabia, from March 2023 to August 2023. Inclusion criteria were: university students aged 18 years and older of both sexes who agreed to participate in the study. The modified Nordic questionnaire was used, which comprised three parts. Out of 536 respondents, 337 were women and 199 were men. The average body mass index (BMI) of the study population was 25.3 ± 4.01. In total, 223 (41.60%) had a history of MSDs. Only 232 (43.28%) of the population did regular exercise. According to multiple logistic regression analysis, factors associated with MSDs are mobile device use (with both hands) with a large neck tilt below the horizon line position (OR = 2.276, CI 1.178-4.397, p = 0.014), family history of trauma (OR = 5.450, 95% CI 3.371-8.811, p = 0.000), family history of MSDs (OR = 4.241, 95% CI 2.296-7.835, p = 0.000), coffee consumption (OR = 1.967, CI 1.281-3.020, p = 0.002), and time spent on electronic devices: 1-3 h (OR = 0.252, 95% CI 0.124-0.511, p = 0.0001), 4-6 h (OR = 0.455, 95% CI 0.237-0.873, p = 0.018), and 6-9 h (OR = 0.348, 95% CI 0.184-0.660, p = 0.001). The present study concludes that MSP among university students is high. A history of trauma, a family history of MSDs, the hand and neck position when using electronic devices, the amount of time spent using them, and regular exercise are risk factors that are strongly associated with MSP. There is strong evidence to suggest that increasing physical activity plays a significant role in enhancing the functionality of the musculoskeletal (MSK) system and alleviating pain. It is recommended that universities implement educational programs to raise awareness and health screenings about the impact of device usage on MSK health and the benefits of regular exercise.

Accuracy of Video-Based Hand Tracking for People With Upper-Body Disabilities.

Utilization of hand-tracking cameras, such as Leap, for hand rehabilitation and functional assessments is an innovative approach to providing affordable alternatives for people with disabilities. However, prior to deploying these commercially-available tools, a thorough evaluation of their performance for disabled populations is necessary. In this study, we provide an in-depth analysis of the accuracy of Leap's hand-tracking feature for both individuals with and without upper-body disabilities for common dynamic tasks used in rehabilitation. Leap is compared against motion capture with conventional techniques such as signal correlations, mean absolute errors, and digit segment length estimation. We also propose the use of dimensionality reduction techniques, such as Principal Component Analysis (PCA), to capture the complex, high-dimensional signal spaces of the hand. We found that Leap's hand-tracking performance did not differ between individuals with and without disabilities, yielding average signal correlations between 0.7-0.9. Both low and high mean absolute errors (between 10-80mm) were observed across participants. Overall, Leap did well with general hand posture tracking, with the largest errors associated with the tracking of the index finger. Leap's hand model was found to be most inaccurate in the proximal digit segment, underestimating digit lengths with errors as high as 18mm. Using PCA to quantify differences between the high-dimensional spaces of Leap and motion capture showed that high correlations between latent space projections were associated with high accuracy in the original signal space. These results point to the potential of low-dimensional representations of complex hand movements to support hand rehabilitation and assessment.

Образ тела девочек-подростков с разным индексом массы тела, имеющих гинекологические заболевания

Background. The study relevance is due to a decrease in publication activity in relation to the object of research in the last 10 years (according to the professional information database LENS.ORG) by 12% compared to the previous decade, while social demand remains high. Objectives. The goal is to identify differences in the structural components of body image, as well as factors involved in its formation in adolescent girls with different body mass indexes and gynecological diseases. Study Participants. 31 teenage girls aged 11–17 years (Mage = 14.06, SD = 2.02 years), having a confirmed gynecological disease according to ICD-10 (menstrual irregularities, inflammatory diseases of the pelvic organs, benign tumors of the pelvic organs and mammary glands). Methods. The study used the author's questionnaire, consisting of 3 substantive blocks of questions (socio-demographic; somatic, socio-psychological data) and 4 psychodiagnostic techniques: Body Image Questionnaire by O.A. Skugarevsky and S.V. Sivukha; SIBID questionnaire (Thomas F. Cash) adapted by L.T. Baranskaya and S.S. Tataurova; Nonverbal technique for assessing satisfaction with body areas (SBS) Meshkova T.A., Neuropsychological tests for somatognosis (right-left orientation in the body diagram, idea of body size in space). Results. Statistically significant differences in the level of dissatisfaction with both their own body and body parts were revealed between the groups of adolescent girls with different BMI values. At the level of somatosensory gnosis, both groups showed disturbances in quasi-spatial orientation (orientation in their own body), which manifested themselves in mirroring errors and difficulty transferring the spatial organization of hand posture in the horizontal and vertical planes of right-left orientation. Statistically significant direct relationships were revealed between BMI values and indicators of dissatisfaction with their own body and situational dissatisfaction with body image. Significant relationships between BMI and the time spent in the digital space, the number of subscribers in social networks, school performance, and diet were revealed. Conclusions. As a result of the conducted research, a significant correlation between body mass index indicators in adolescent girls with gynecological diseases with such indicators as satisfaction/dissatisfaction with their own body and their body image, time spent in the digital space and the number of subscribers, school performance, as well as diet was revealed.

HDE-Array: Development and Validation of a New Dry Electrode Array Design to Acquire HD-sEMG for Hand Position Estimation.

This paper aims to introduce HDE-Array (High-Density Electrode Array), a novel dry electrode array for acquiring High-Density surface electromyography (HD-sEMG) for hand position estimation through RPC-Net (Recursive Prosthetic Control Network), a neural network defined in a previous study. We aim to demonstrate the hypothesis that the position estimates returned by RPC-Net using HD-sEMG signals acquired with HDE-Array are as accurate as those obtained from signals acquired with gel electrodes. We compared the results, in terms of precision of hand position estimation by RPC-Net, using signals acquired by traditional gel electrodes and by HDE-Array. As additional validation, we performed a variance analysis to confirm that the presence of only two rows of electrodes does not result in an excessive loss of information, and we characterized the electrode-skin impedance to assess the effects of the voltage divider effect and power line interference. Performance tests indicated that RPC-Net, used with HDE-Array, achieved comparable or superior results to those observed when used with the gel electrode setup. The dry electrodes demonstrated effective performance even with a simplified setup, highlighting potential cost and usability benefits. These results suggest improvements in the accessibility and user-friendliness of upper-limb rehabilitation devices and underscore the potential of HDE-Array and RPC-Net to revolutionize control for medical and non-medical applications.

Electrical Stimulation of Regenerative Peripheral Nerve Interfaces (RPNIs) Induces Referred Sensations in People With Upper Limb Loss.

Individuals with upper limb loss lack sensation of the missing hand, which can negatively impact their daily function. Several groups have attempted to restore this sensation through electrical stimulation of residual nerves. The purpose of this study was to explore the utility of regenerative peripheral nerve interfaces (RPNIs) in eliciting referred sensation. In four participants with upper limb loss, we characterized the quality and location of sensation elicited through electrical stimulation of RPNIs over time. We also measured functional stimulation ranges (sensory perception and discomfort thresholds), sensitivity to changes in stimulation amplitude, and ability to differentiate objects of different stiffness and sizes. Over a period of up to 54 months, stimulation of RPNIs elicited sensations that were consistent in quality (e.g. tingling, kinesthesia) and were perceived in the missing hand and forearm. The location of elicited sensation was partially-stable to stable in 13 of 14 RPNIs. For 5 of 7 RPNIs tested, participants demonstrated a sensitivity to changes in stimulation amplitude, with an average just noticeable difference of 45 nC. In a case study, one participant was provided RPNI stimulation proportional to prosthetic grip force. She identified four objects of different sizes and stiffness with 56% accuracy with stimulation alone and 100% accuracy when stimulation was combined with visual feedback of hand position. Collectively, these experiments suggest that RPNIs have the potential to be used in future bi-directional prosthetic systems.

The Hand Position Concept for Control of Underactuated Underwater Vehicles

The Hand Position Concept for Control of Underactuated Underwater Vehicles

Intra-session reliability of isometric muscle strength of the bilateral standing press in female handball players.

Systematizing reliable protocols and procedures for strength assessment in handball has allowed for a more thorough kinetic analysis and increased precision in detecting training-induced changes in muscular strength. The evaluation of upper limb strength with a bilateral standing press (BSP) exercise in handball players approximates blocking actions in the defensive phase, pushing and fixation. The aim of this study was to analyze the relative and absolute reliability of intra-session comparisons in an isometric peak muscle strength protocol in a bilateral standing press (BSP) exercise among female handball players. Sixteen young female handball players at an international level, aged between 22 ± 4 years, with no prior experience in using functional electromechanical dynamometers (FEMD) participated in this study. The participants initiated the assessment of maximum isometric force in a bipedal stance with a forward projection of the dominant foot between 20 and 30 cm. The knees were kept semi-flexed, and the hip extension of the non-dominant limb ranged from 15 to 20°. Bilateral anterior push of the upper limb was performed with shoulder abduction and elbow flexion at 90°, maintaining a pronated hand position. Participants were instructed to exert three sets of maximal force for 5 s in BSP exercise. Relative reliability was assessed using the model intraclass correlation (ICC) and absolute reliability was assessed using the coefficient of variation (CV) and standard error of measurement (SEM). For this study, the parameters of maximum and mean muscle strength were considered. The results demonstrated high relative reliability (ICC 0.93-0.97) and absolute reliability (SEM 0.19-2.79) y (CV 4.78-9.03) for both mean force and peak force, with no significant differences between the sets (p > 0.05), indicating a negligible effect size (0.01-0.12). The mean and peak isometric muscle strength for the BSP exercise controlled with FEMD in female handball players exhibits high relative and absolute reliability between series.

Exoscope-based supracerebellar infratentorial approach for a pineal meningioma in the prone position.

The supracerebellar infratentorial (SCIT) approach is a well-described corridor to lesions in the quadrigeminal cistern, pineal gland, and dorsal midbrain. It can be performed in the prone or sitting position. The sitting position offers the benefit of gravity retraction of the cerebellum but comes at the expense of nonergonomic hand positioning and the potential risk of air embolism. The 3D exoscope is an alternative to the operating microscope and permits the SCIT approach in the prone position with excellent visualization. This video demonstrates exoscope-based SCIT approach for resection of a pineal meningioma in the prone position. The video can be found here: https://stream.cadmore.media/r10.3171/2023.10.FOCVID23155.