How Scotland’s First 3D Exoscope Helped Teen Toby Peart Heal

Toby Peart is back in his Highland secondary school this term, months after becoming one of the first patients in Scotland to have a brain tumour cut out using a 3D exoscope. Doctors at NHS Greater Glasgow and Clyde (NHSGGC) had warned the operation could cost the 13-year-old his speech, movement and feeling down his left side. He was moving his fingers again within a day.

The technology behind that recovery, a robotic camera called the Aesculap Aeos, is quietly replacing the eyepiece microscope that has defined brain surgery for almost seventy years.

Pins and Needles That Turned Out to Be a Tumour

Toby began feeling pins and needles and pain in his left leg in April 2025. What looked at first like growing pains crept in slowly, then worsened over several months.

An MRI scan at Raigmore Hospital in Inverness found a tumour on the right side of his brain, measuring roughly 13 to 14mm. Within days, doctors referred him from the Highlands to the Royal Hospital for Children in Glasgow for specialist treatment.

Further investigation confirmed surgery was necessary. Toby’s father, Marc, said: “It was without question the hardest few weeks of our lives.”

What Does the Aesculap Aeos Actually Change in Theatre?

The Aesculap Aeos is a robotic arm holding a 3D, high-definition camera above the patient instead of a microscope the surgeon presses their eyes into. It projects the surgical field onto large screens, letting the whole team watch in 3D while the lead surgeon operates sitting upright rather than hunched over eyepieces.

NHSGGC ran the system through a trial period before fully integrating it into regular neurosurgical practice, which is part of why Toby’s case, operated on in November, is only being detailed publicly now. Roddy O’Kane, consultant neurosurgeon at NHS Greater Glasgow and Clyde, described the shift bluntly.

“Traditionally, neurosurgery meant working for hours with your eyes fixed to microscope eyepieces,” O’Kane said of the system NHSGGC has now fully integrated. “This technology allows us to operate upright while gaining views and angles that simply aren’t possible with conventional microscopes.”

• Upright posture – surgeons watch a screen rather than bending into eyepieces for hours at a stretch
• Shared 3D view – large screens let the whole surgical team, including trainees and students, watch the same three-dimensional image live
• Brighter, cooler light – LED illumination cuts the thermal damage and tissue glare that conventional microscope light can cause
• Longer reach – an extended working distance gives surgeons room to manoeuvre instruments without the camera getting in the way

For a 13-year-old with a tumour pressed against tissue that controls movement and sensation, that extra margin of clarity was the difference doctors were counting on. “For children undergoing brain surgery, that enhanced visualisation can make a real difference,” O’Kane said. “The ability to see more clearly and reach more effectively supports safer surgery and, ultimately, better outcomes.”

Seventy Years of Eyepieces Meet Their Rival

The operating microscope has been neurosurgery’s default tool for generations. It was first introduced in the late 1950s and became the gold standard for intraoperative visualisation, prized for its ability to illuminate and magnify delicate anatomy no other tool could show clearly.

A small cluster of digital rivals has chipped at that dominance over the past decade, each built by a different manufacturer, each chasing the same idea: pull the surgeon’s eyes off the eyepiece and onto a shared screen.

NHSGGC’s decision to fully integrate the Aeos this year put Scotland into that small international club for the first time.

Glasgow Joins a Fast-Moving Global List

Glasgow is not alone in making this switch. In April 2026, Banner Thunderbird Medical Center in Glendale, Arizona, became the first hospital in the West to use an innovative robotic exoscope for brain tumor neurosurgery, adopting the same Aesculap platform to let surgeons operate from a screen instead of a microscope.

Glasgow’s own standing had already been growing before the Aeos arrived. The Royal Hospital for Children was named a Tessa Jowell Centre of Excellence for children with brain tumours, one of only six paediatric units across the UK to hold that designation, alongside Royal Aberdeen Children’s Hospital.

Reviewers praised the hospital’s chemotherapy access, its integrated teams and its rehabilitation and play services. The exoscope arrived on top of a unit already being singled out for how it treats children through an entire illness, not just through one operation.

Toby’s Fingers Started Moving the Next Morning

Some of the effects doctors had warned about did show up right after surgery, Marc said on BBC Radio Scotland’s Breakfast programme. Speech, movement and sensation on Toby’s left side were all at risk going in.

But his personality never wavered, his father said. “We knew Toby, in terms of his personality, was still there,” Marc said. His son’s first request after waking was simple.

The morning after the operation, Marc woke to his son holding up his left hand with his right.

I woke up with him saying, dad, dad, look. He was holding his left hand up with his right hand and he just said, ‘my fingers are doing fingery things’.

Marc Peart, Toby’s father, recounted the moment on BBC Radio Scotland’s Breakfast programme.

Movement kept improving over the following day. Toby was discharged the following week, in time for Christmas, and returned to school for the new term in January.

The Cancer That Kills More UK Children Than Any Other

Toby’s case landed inside a disease category with grim national numbers behind it. Brain tumours remain the biggest cancer killer of children and young adults under 40 in the UK, according to The Brain Tumour Charity.

• 13,000 diagnoses – people in the UK told they have a primary brain tumour each year
• 12.9% vs 56% – five-year survival for brain cancer in England against the average across all cancers
• 27 years – the average cut to life expectancy brain cancer causes
• Under 40s – the age bracket in which brain tumours kill more people than any other cancer

Toby’s tumour was caught, treated and, so far, resolved without the outcomes those numbers describe. He is back in his Highland classroom this year, one of the fast recoveries doctors in Glasgow now hope the Aeos can help make more common.

Frequently Asked Questions

What is the difference between an exoscope and an endoscope?

An exoscope sits outside the body and projects a magnified 3D view of the surgical field onto external screens. An endoscope is inserted into the body through a small opening; it allows flexible viewing in tight spaces, but its shorter focal range reduces depth perception and stereoscopic vision compared with an exoscope’s longer working distance.

Is the Aesculap Aeos a robot that operates on its own?

No. The word robotic refers to the arm that holds and repositions the camera above the patient, not an automated surgeon. A neurosurgeon still performs every cut and movement by hand while viewing the magnified 3D image on a screen, moving between angles the arm makes possible.

How many children does Glasgow’s Royal Hospital for Children treat for brain tumours each year?

Around 30 children a year are newly diagnosed with a brain tumour at the Royal Hospital for Children in Glasgow, one of only six paediatric units in the UK holding the Tessa Jowell Centre of Excellence for Children designation.

Had 3D exoscope surgery been used on children before Toby Peart?

Yes, elsewhere in the world. Surgeons in Germany and other countries have used earlier 3D exoscope models such as the VITOM in pediatric neurosurgery for close to a decade. NHS Greater Glasgow and Clyde’s installation is a first for Scotland specifically, not for the technology worldwide.