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.

Zappa, F., Madoglio, A., Ferrari, M., Mattavelli, D., Schreiber, A., Taboni, S., Ferrari, E., Rampinelli, V., Belotti, F., Piazza, C., Fontanella, M. M., Nicolai, P., Doglietto, F., Hybrid Robotics for Endoscopic Transnasal Skull Base Surgery: Single-Centre Case Series, <<OPERATIVE NEUROSURGERY>>, 2021; 21 (6): 426-435. [doi:10.1093/ons/opab327] [http://hdl.handle.net/10807/206568]

Hybrid Robotics for Endoscopic Transnasal Skull Base Surgery: Single-Centre Case Series

Fontanella, M. M.;Doglietto, F.
Ultimo
2021

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.
Inglese
Zappa, F., Madoglio, A., Ferrari, M., Mattavelli, D., Schreiber, A., Taboni, S., Ferrari, E., Rampinelli, V., Belotti, F., Piazza, C., Fontanella, M. M., Nicolai, P., Doglietto, F., Hybrid Robotics for Endoscopic Transnasal Skull Base Surgery: Single-Centre Case Series, <<OPERATIVE NEUROSURGERY>>, 2021; 21 (6): 426-435. [doi:10.1093/ons/opab327] [http://hdl.handle.net/10807/206568]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/206568
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