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Sahin MS, Gulsever CI, Ozturk M, Dolen D, Dolas I, Saglam L, Coskun O, Gayretli O, Sabanci PA. Use of a Novel Steerable Tip Suction Cannula in Large and Giant Pituitary Adenomas: A Cadaveric Feasibility Study. Surg Innov 2025; 32:149-154. [PMID: 39789909 DOI: 10.1177/15533506251313861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2025]
Abstract
ObjectiveThe endoscopic transsphenoidal approach is commonly used for sellar and suprasellar pathologies. However, reaching above the diaphragma sella, especially for posterosuperior and retrocavernous orientation, still poses some challenges. We designed and developed a steerable tip suction cannula (STSC) that has distinct leverage for endoscopic resection of such pathologies.MethodsThe entire suction cannula is made of stainless steel. The instrument consists of a handle, vacuum tube, suction tip bed, suction tip, finger knuckle, wire path, countersunk headpin, and isolated steel wire. The working principle of the product is to enable the surgeon to move the aspiration tip in the desired direction by steering the finger knuckle. Five cadaveric specimens fixed with the saturated salt solution were used to evaluate the instrument and obtain measurements.ResultsIn the straight position, the STSC aspirated 2.67% slower than the control aspirator tip and 13.24% faster than that at 30° angulation. Based on the CT measurements, the mean angulation of the instrument from the frontobasal axis was 38.3°. The mean distance from the frontobasal axis was 1.3 cm. The average angulation of the tip of the instrument in the cranium was 25.5°.ConclusionThe designed STSC might effectively resect large to giant pituitary adenomas, especially those with supradiaphragmatic extension. Its suction capability is comparable to that of conventional suction tubes.
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Affiliation(s)
- Mustafa Selim Sahin
- Department of Neurosurgery, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Cafer Ikbal Gulsever
- Department of Neurosurgery, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Metehan Ozturk
- Department of Neurosurgery, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Duygu Dolen
- Department of Neurosurgery, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Ilyas Dolas
- Department of Neurosurgery, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Latif Saglam
- Department of Anatomy, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Osman Coskun
- Department of Anatomy, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Ozcan Gayretli
- Department of Anatomy, Istanbul University, Faculty of Medicine, Istanbul, Turkey
| | - Pulat Akin Sabanci
- Department of Neurosurgery, Istanbul University, Faculty of Medicine, Istanbul, Turkey
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2
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Rabbin-Birnbaum C, Wiggan DD, Sangwon KL, Negash B, Gutstadt E, Rutledge C, Baranoski J, Raz E, Shapiro M, Sharashidze V, Riina HA, Nelson PK, Liu A, Choudhry O, Nossek E. Learning Curve of Robotic End-to-Side Microanastomoses. Oper Neurosurg (Hagerstown) 2024; 27:724-729. [PMID: 38717168 DOI: 10.1227/ons.0000000000001187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/10/2024] [Indexed: 04/24/2025] Open
Abstract
BACKGROUND AND OBJECTIVES Robotics are becoming increasingly widespread within various neurosurgical subspecialties, but data pertaining to their feasibility in vascular neurosurgery are limited. We present our novel attempt to evaluate the learning curve of a robotic platform for microvascular anastomoses. METHODS One hundred and sixty one sutures were performed and assessed. Fourteen anastomoses (10 robotic [MUSA-2 Microsurgical system; Microsure] and 4 hand-sewn) were performed by the senior author on 1.5-mm caliber tubes and recorded with the Kinevo 900 (Zeiss) operative microscope. We separately compared interrupted sutures (from needle insertion until third knot) and running sutures (from needle insertion until loop pull-down). Average suture timing across all groups was compared using an unpaired Student's t test. Exponential smoothing (α = 0.2) was then applied to the robotic data sets for validation and a second set of t tests were performed. RESULTS We compared 107 robotic sutures with 54 hand-sewn sutures. There was a significant difference between the average time/stitch for the robotic running sutures (n = 55) and the hand-sewn running sutures (n = 31) (31.2 seconds vs 48.3 seconds, respectively; P -value = .00052). Exponential smoothing (α = 0.2) reinforced these results (37.6 seconds vs 48.3 seconds; P -value = .014625). Average robotic running times surpassed hand-sewn by the second anastomosis (38.8 seconds vs 48.3 seconds) and continued to steadily decrease with subsequent stitches. The average of the robotic interrupted sutures (n = 52) was significantly longer than the hand-sewn (n = 23) (171.3 seconds vs 70 seconds; P = .000024). Exponential smoothing (α = 0.2) yielded similar results (196.7 seconds vs 70 seconds; P = .00001). However, average robotic interrupted times significantly decreased from the first to the final anastomosis (286 seconds vs 105.2 seconds; P = .003674). CONCLUSION Our results indicate the learning curve for robotic microanastomoses is short and encouraging. The use of robotics warrants further study for potential use in cerebrovascular bypass procedures.
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Affiliation(s)
| | | | - Karl L Sangwon
- NYU Grossman School of Medicine, New York , New York , USA
| | - Bruck Negash
- NYU Grossman School of Medicine, New York , New York , USA
| | | | - Caleb Rutledge
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Jacob Baranoski
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Eytan Raz
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Maksim Shapiro
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Vera Sharashidze
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Howard A Riina
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Peter Kim Nelson
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Albert Liu
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Osamah Choudhry
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
| | - Erez Nossek
- Department of Neurosurgery, NYU Langone Health, New York , New York , USA
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3
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Seghier ML. 7 T and beyond: toward a synergy between fMRI-based presurgical mapping at ultrahigh magnetic fields, AI, and robotic neurosurgery. Eur Radiol Exp 2024; 8:73. [PMID: 38945979 PMCID: PMC11214939 DOI: 10.1186/s41747-024-00472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 04/22/2024] [Indexed: 07/02/2024] Open
Abstract
Presurgical evaluation with functional magnetic resonance imaging (fMRI) can reduce postsurgical morbidity. Here, we discuss presurgical fMRI mapping at ultra-high magnetic fields (UHF), i.e., ≥ 7 T, in the light of the current growing interest in artificial intelligence (AI) and robot-assisted neurosurgery. The potential of submillimetre fMRI mapping can help better appreciate uncertainty on resection margins, though geometric distortions at UHF might lessen the accuracy of fMRI maps. A useful trade-off for UHF fMRI is to collect data with 1-mm isotropic resolution to ensure high sensitivity and subsequently a low risk of false negatives. Scanning at UHF might yield a revival interest in slow event-related fMRI, thereby offering a richer depiction of the dynamics of fMRI responses. The potential applications of AI concern denoising and artefact removal, generation of super-resolution fMRI maps, and accurate fusion or coregistration between anatomical and fMRI maps. The latter can benefit from the use of T1-weighted echo-planar imaging for better visualization of brain activations. Such AI-augmented fMRI maps would provide high-quality input data to robotic surgery systems, thereby improving the accuracy and reliability of robot-assisted neurosurgery. Ultimately, the advancement in fMRI at UHF would promote clinically useful synergies between fMRI, AI, and robotic neurosurgery.Relevance statement This review highlights the potential synergies between fMRI at UHF, AI, and robotic neurosurgery in improving the accuracy and reliability of fMRI-based presurgical mapping.Key points• Presurgical fMRI mapping at UHF improves spatial resolution and sensitivity.• Slow event-related designs offer a richer depiction of fMRI responses dynamics.• AI can support denoising, artefact removal, and generation of super-resolution fMRI maps.• AI-augmented fMRI maps can provide high-quality input data to robotic surgery systems.
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Affiliation(s)
- Mohamed L Seghier
- Department of Biomedical Engineering and Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, UAE.
- Healtcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, UAE.
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4
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Pérez de la Torre RA, Ramanathan S, Williams AL, Perez-Cruet M. Minimally-Invasive Assisted Robotic Spine Surgery (MARSS). Front Surg 2022; 9:884247. [PMID: 35903260 PMCID: PMC9316616 DOI: 10.3389/fsurg.2022.884247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Minimally-Invasive robotic spine surgery (MARSS) has expanded the surgeons armamentarium to treat a variety of spinal disorders. In the last decade, robotic developments in spine surgery have improved the safety, accuracy and efficacy of instrumentation placement. Additionally, robotic instruments have been applied to remove tumors in difficult locations while maintaining minimally invasive access. Gross movements by the surgeon are translated into fine, precise movements by the robot. This is exemplified in this chapter with the use of the da Vinci robot to remove apical thoracic tumors. In this chapter, we will review the development, technological advancements, and cases that have been conducted using MARSS to treat spine pathology in a minimally invasive fashion.
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Affiliation(s)
| | - Siddharth Ramanathan
- Department of Neurosurgery, Oakland University William Beaumont, School of Medicine, Royal Oak, MI, United States
| | - Ashley L. Williams
- Department of Neurosurgery, Oakland University William Beaumont, School of Medicine, Royal Oak, MI, United States
| | - Mick J. Perez-Cruet
- Department of Neurosurgery, Oakland University William Beaumont, School of Medicine, Royal Oak, MI, United States
- Michigan Head and Spine Institute, Southfield, MI, United States
- Correspondence: Mick Perez-Cruet
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5
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Curry BP, Alvarez R, Widemann BC, Johnson M, Agarwal PK, Lehky T, Valera V, Chittiboina P. Robotic Nerve Sheath Tumor Resection With Intraoperative Neuromonitoring: Case Series and Systematic Review. Oper Neurosurg (Hagerstown) 2022; 22:44-50. [PMID: 35007270 PMCID: PMC9524598 DOI: 10.1227/ons.0000000000000051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 09/13/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Retroperitoneal nerve sheath tumors present a surgical challenge. Despite potential advantages, robotic surgery for these tumors has been limited. Identifying and sparing functional nerve fascicles during resection can be difficult, increasing the risk of neurological morbidity. OBJECTIVE To review the literature regarding robotic resection of retroperitoneal nerve sheath tumors and retrospectively analyze our experience with robotic resection of these tumors using a manual electromyographic probe to identify and preserve functional nerve fascicles. METHODS We retrospectively analyzed the clinical courses of 3 patients with retroperitoneal tumors treated at the National Institutes of Health by a multidisciplinary team using the da Vinci Xi system. Parent motor nerve fascicles were identified intraoperatively with a bipolar neurostimulation probe inserted through a manual port, permitting tumor resection with motor fascicle preservation. RESULTS Two patients with neurofibromatosis type 1 underwent surgery for retroperitoneal neurofibromas located within the iliopsoas muscle, and 1 patient underwent surgery for a pelvic sporadic schwannoma. All tumors were successfully resected, with no complications or postoperative neurological deficits. Preoperative symptoms were improved or resolved in all patients. CONCLUSION Resection of retroperitoneal nerve sheath tumors confers an excellent prognosis, although their deep location and proximity to vital structures present unique challenges. Robotic surgery with intraoperative neurostimulation mapping is safe and effective for marginal resection of histologically benign or atypical retroperitoneal nerve sheath tumors, providing excellent visibility, increased dexterity and precision, and reduced risk of neurological morbidity.
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Affiliation(s)
- Brian P. Curry
- Division of Neurosurgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA;
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA;
| | - Reinier Alvarez
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA;
- Neurosurgery Unit for Pituitary and Inheritable Diseases, National Institute of Neurological Diseases and Stroke, Bethesda, Maryland, USA;
- Florida International University Herbert Wertheim College of Medicine, Miami, Florida, USA;
| | - Brigitte C. Widemann
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA;
| | - Matthew Johnson
- Electromyography Section, National Institute of Neurological Diseases and Stroke, Bethesda, Maryland, USA;
| | - Piyush K. Agarwal
- Department of Surgery, Urology Section, Comprehensive Cancer Center, The University of Chicago, Chicago, Illinois, USA;
| | - Tanya Lehky
- Electromyography Section, National Institute of Neurological Diseases and Stroke, Bethesda, Maryland, USA;
| | - Vladimir Valera
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Prashant Chittiboina
- Neurosurgery Unit for Pituitary and Inheritable Diseases, National Institute of Neurological Diseases and Stroke, Bethesda, Maryland, USA;
- Florida International University Herbert Wertheim College of Medicine, Miami, Florida, USA;
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Al-Salihi MM, Ayyad A, Al-Jebur MS, Rahman MM. Letter to the Editor Regarding "Global Research Trends in Robotic Application in Neurosurgery: A Systematic Bibliometric Analysis". World Neurosurg 2021; 157:244-245. [PMID: 34929771 DOI: 10.1016/j.wneu.2021.09.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/15/2022]
Affiliation(s)
| | - Ali Ayyad
- Department of Neurosurgery, Saarland University Hospital, Homburg, Germany; Department of Neurosurgery, Hamad General Hospital, Doha, Qatar
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Rotim K, Splavski B, Vrban F. THE SAFETY AND EFFICACY OF ROBOT-ASSISTED STEREOTACTIC BIOPSY FOR BRAIN GLIOMA: EARLIEST INSTITUTIONAL EXPERIENCES AND EVALUATION OF LITERATURE. Acta Clin Croat 2021; 60:296-303. [PMID: 34744281 PMCID: PMC8564848 DOI: 10.20471/acc.2021.60.02.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 05/27/2021] [Indexed: 11/24/2022] Open
Abstract
Robot-assisted brain tumor biopsy is becoming one of the most important innovative technologies in neurosurgical practice. The idea behind its engagement is to advance the safety and efficacy of the biopsy procedure, which is much in demand when planning the management of endocranial tumor pathology. Herein, we provide our earliest institutional experiences in utilizing this mesmerizing technology. Cranial robotic device was employed for stereotactic robot-assisted brain glioma biopsy in three consecutive patients from our series: an anaplastic isocitrate dehydrogenase (IDH) negative astrocytoma (WHO grade III) located in the right trigone region of the periventricular white matter; a low grade diffuse astrocytoma (WHO grade II) of bilateral thalamic region spreading into the right mesencephalic area; and an IDH-wildtype glioblastoma (WHO grade IV) of the right frontal lobe producing a contralateral midline shifting. Robot-assisted tumor biopsy was successfully performed to get tissue samples for histopathologic and immunohistochemical analysis. The adjacent tissue iatrogenic damage of the eloquent cortical areas was minimal, while the immediate postoperative recovery was satisfactory in all patients. In conclusion, considering the preliminary results of our early experiences, robot-assisted tumor biopsy was proven to be a feasible and accurate procedure when surgery for brain glioma was not an option. It may increase safety and precision, without expanding surgical time, being similarly effective when compared to standard stereotactic and manual biopsy. Using this method to provide accurate sampling for histopathologic and immunohistochemical analysis is a safe and easy way to determine management strategies and outcome of different types of brain glioma.
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Affiliation(s)
| | - Bruno Splavski
- 1Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 3University of Applied Health Sciences, Zagreb, Croatia; 4Josip Juraj Strossmayer University of Osijek, Faculty of Dental Medicine and Health, Osijek, Croatia
| | - Filip Vrban
- 1Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 3University of Applied Health Sciences, Zagreb, Croatia; 4Josip Juraj Strossmayer University of Osijek, Faculty of Dental Medicine and Health, Osijek, Croatia
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8
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Ferrarez CE, Bertani R, Koester S, Perret C, Leal RS, Gusmão S, Maluf FB, Oliveira MM, Landeiro JA. Fully endoscopic clipping of anterior circulation cerebral aneurysms through transpalpebral approach: One step closer to robotic neurovascular surgery? J Clin Neurosci 2021; 88:142-146. [PMID: 33992173 DOI: 10.1016/j.jocn.2021.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 02/13/2021] [Accepted: 03/11/2021] [Indexed: 11/19/2022]
Affiliation(s)
- C E Ferrarez
- Hospital Madre Teresa, Belo Horizonte, MG, Brazil.
| | - R Bertani
- Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil.
| | - S Koester
- University of Vanderbilt, School of Medicine, Nashville, TN, USA
| | - C Perret
- Hospital Municipal Miguel Couto, Rio de Janeiro, RJ, Brazil
| | - R S Leal
- Hospital Madre Teresa, Belo Horizonte, MG, Brazil
| | - S Gusmão
- Hospital Madre Teresa, Belo Horizonte, MG, Brazil
| | - F B Maluf
- Hospital Madre Teresa, Belo Horizonte, MG, Brazil
| | - M M Oliveira
- Hospital Madre Teresa, Belo Horizonte, MG, Brazil
| | - J A Landeiro
- Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil.
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9
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Lozada-Martínez I, Maiguel-Lapeira J, Torres-Llinás D, Moscote-Salazar L, Rahman MM, Pacheco-Hernández A. Letter: Need and Impact of the Development of Robotic Neurosurgery in Latin America. Neurosurgery 2021; 88:E580-E581. [PMID: 33822187 DOI: 10.1093/neuros/nyab088] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ivan Lozada-Martínez
- Medical and Surgical Research Center School of Medicine University of Cartagena Cartagena, Colombia.,Latinamerican Council of Neurocritical Care (CLaNi) Cartagena, Colombia.,Colombian Clinical Research Group in Neurocritical Care School of Medicine University of Cartagena Cartagena, Colombia
| | - Juan Maiguel-Lapeira
- Medical and Surgical Research Center School of Medicine University of Cartagena Cartagena, Colombia
| | - Daniela Torres-Llinás
- Medical and Surgical Research Center School of Medicine University of Cartagena Cartagena, Colombia
| | - Luis Moscote-Salazar
- Medical and Surgical Research Center School of Medicine University of Cartagena Cartagena, Colombia.,Latinamerican Council of Neurocritical Care (CLaNi) Cartagena, Colombia.,Colombian Clinical Research Group in Neurocritical Care School of Medicine University of Cartagena Cartagena, Colombia
| | - Md Moshiur Rahman
- Neurosurgery Department Holy Family Red Crescent Medical College Dhaka, Bangladesh
| | - Alfonso Pacheco-Hernández
- Medical and Surgical Research Center School of Medicine University of Cartagena Cartagena, Colombia.,Colombian Clinical Research Group in Neurocritical Care School of Medicine University of Cartagena Cartagena, Colombia
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Abstract
This paper provides a brief history of medical robotic systems. Since the first use of robots in medical procedures, there have been countless companies competing to developed robotic systems in hopes to dominate a field. Many companies have succeeded, and many have failed. This review paper shows the timeline history of some of the old and most successful medical robots and new robotic systems. As the patents of the most successful system, i.e., Da Vinci® Surgical System, have expired or are expiring soon, this paper can provide some insights for new designers and manufacturers to explore new opportunities in this field.
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Soldozy S, Young S, Yağmurlu K, Norat P, Sokolowski J, Park MS, Jane JA, Syed HR. Transsphenoidal surgery using robotics to approach the sella turcica: Integrative use of artificial intelligence, realistic motion tracking and telesurgery. Clin Neurol Neurosurg 2020; 197:106152. [PMID: 32858256 DOI: 10.1016/j.clineuro.2020.106152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/07/2020] [Accepted: 08/09/2020] [Indexed: 11/27/2022]
Abstract
While full integration of robotic surgery has been achieved in other surgical domains, its transition into neurosurgery has been more prolonged, especially with respect to pituitary surgery. The confined working space and precise maneuvers required in endoscopic endonasal surgery makes development of an efficacious and safe robotic system difficult. Nevertheless, preclinical studies have attempted to demonstrate the feasibility of the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) in both transnasal and transoral approaches. In addition, unique robotics such as the concentric tube robot have been created. This system is optimized specifically for anterior skull base surgery with smaller shaft diameter arms and improved maneuverability in tight corridors. The possible role of concentric tube robotics surgery in skull base pathologies has been explored, and the novel use of telesurgery incorporated into robotic neurosurgery is discussed. An endoscopic endonasal transsphenoidal surgical system has also been developed, integrating computational methods to create a presurgical reconstructive model for surgical planning and automating the line of dissection for an enhanced approach to the sphenoid sinus. While surgical robotics for transsphenoidal surgery remain in its nascency, these preliminary findings are promising and suggest a role for robotic pituitary surgery.
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Affiliation(s)
- Sauson Soldozy
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Steven Young
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Kaan Yağmurlu
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Pedro Norat
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Jennifer Sokolowski
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Min S Park
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - John A Jane
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States
| | - Hasan R Syed
- Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia, United States.
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