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논문 기본 정보

자료유형
학술저널
저자정보
Jun Muto (Department of Neurosurgery, Fujita Health University) Ichiro Tateya (Department of Otolaryngology-Head and Neck Surgery, Fujita Health University) Hirofumi Nakatomi (Department of Neurosurgery, Kyorin University) Ichiro Uyama (Department of General Surgery, Fujita Health University) Yuichi Hirose (Department of Neurosurgery, Fujita Health University)
저널정보
대한척추신경외과학회 Neurospine Neurospine Vol.21 No.1
발행연도
2024.3
수록면
106 - 115 (10page)
DOI
10.14245/ns.2448062.031

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초록· 키워드

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Objective: The application of the da Vinci Surgical System in neurosurgery is limited due to technical difficulties requiring precise maneuvers and small instruments. This study details the advantages and disadvantages of robotics in neurosurgery and the reachable range of the transoral approach to lesions of the skull base and upper cervical spine. Methods: In a cadaver study, the da Vinci Xi robot, lacking haptic feedback, was utilized for sagittal and coronal approaches on 5 heads, facilitating dura suturing in 3, with a 30°-angled drill for bone removal. Results: Perfect exposure of all the nasopharyngeal sites, clivus, sellar, and choana, including the bilateral eustachian tubes, was achieved without any external incisions using this palatal split approach of transoral robotic surgery. The time required to perform a single stitch, knot, and complete single suture in robotic suturing of deep-seated were significantly less compared to manual suturing via the endonasal approach. Conclusion: This is the first report to show the feasibility of suturing the dural defect in deepseated lesions transorally and revealed that the limit of reach in the coronal plane via a transoral approach with incision of the soft palate is the foramen ovale. This preclinical investigation also showed that the transoral robotic approach is feasible for lesions extending from the sellar to the C2 in the sagittal plane. Refinement of robotic instruments for specific anatomic sites and future neurosurgical studies are needed to further demonstrate the feasibility and effectiveness of this system in treating benign and malignant skull base lesions.

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