Hybrid Robotics for Endoscopic Transnasal Skull Base Surgery: Single-Centre Case Series.
Oper Neurosurg (Hagerstown)
; 21(6): 426-435, 2021 11 15.
Article
em En
| MEDLINE
| ID: mdl-34624091
ABSTRACT
BACKGROUND:
Only preclinical studies and case reports have described robotic surgery for endoscopic transnasal skull base surgery.OBJECTIVE:
To evaluate the role of a novel robotic endoscope holder, developed for transsphenoidal surgery.METHODS:
Patients were prospectively enrolled for 3 mo at the Neurosurgery Unit of Brescia. Endoscope Robot® was used to assist during the sphenoidal phase of the approach, tumor removal, and skull base reconstruction. A Likert scale questionnaire was given to all surgeons after each procedure. Patients who underwent robotic-assisted surgery were matched with nonrobotic ones for pathology and type of procedure. All surgical videos were evaluated during bimanual phases.RESULTS:
Twenty-one patients underwent robot-assisted, endoscopic transsphenoidal surgery for different pathologies (16 pituitary adenomas, 3 chordomas, 1 craniopharyngioma, 1 pituitary exploration for Cushing disease) for a total of 23 procedures (1 patient underwent 2 endoscopic revisions of a skull base reconstruction). Subjective advantages reported by surgeons included smoothness of movement, image steadiness, and improvement of maneuvers in narrow spaces and with angled endoscopes; as the main limitation, Endoscope Robot® appeared to be relatively heavy during the initial endoscope positioning. A comparative analysis with a historical matched cohort documented similar clinical outcomes, while endoscope lens cleaning and position readjustments were significantly less frequent in robotic procedures.CONCLUSION:
Although confirmation in larger studies is needed, Endoscope Robot® was a safe and effective tool, especially advantageous in lengthy interventions through deep and narrow corridors.Palavras-chave
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Robótica
/
Procedimentos Cirúrgicos Robóticos
Limite:
Humans
Idioma:
En
Revista:
Oper Neurosurg (Hagerstown)
Ano de publicação:
2021
Tipo de documento:
Article