Ch Nimsky1, J Rachinger, H Iro, R Fahlbusch. 1. Department of Neurosurgery, University Erlangen-Nürnberg, Erlangen, Germany. nimsky@nch.imed.uni-erlangen.de
Abstract
OBJECTIVE: To adapt a hexapod-based robotic system for use in extended endoscope-assisted transsphenoidal skull base surgery. METHODS: A robotic system (Evolution 1, Universal Robot Systems, Schwerin, Germany) based on a hexapod design with an attached seventh axis is used as instrument holder. The instrument interface is operated via a joystick control. An endoscope is applied to the instrument interface, which is tracked by a navigation system (Stealth, Medtronic, USA). RESULTS: The instrument holder was modified so that it could be applied in transsphenoidal surgery. Furthermore, translation and pivoting movements of the system were implemented, also a quick change between microscope and robotic-controlled endoscope was made possible. After extensive phantom testing two patients with large invasive pituitary adenomas were operated on using the robotic endoscope assistance during transsphenoidal surgery. The robotic assistance allowed the use of two additional instruments under endoscopic view. For example, drilling, suctioning, application of punches, as well as microsurgical tumor removal could be performed under endoscopic view. CONCLUSION: A robotic system could be adapted for use in endoscope-assisted transsphenoidal skull base surgery allowing simultaneous use of two instruments under endoscopic view. This opens new possibilities to extend transsphenoidal skull base surgery.
OBJECTIVE: To adapt a hexapod-based robotic system for use in extended endoscope-assisted transsphenoidal skull base surgery. METHODS: A robotic system (Evolution 1, Universal Robot Systems, Schwerin, Germany) based on a hexapod design with an attached seventh axis is used as instrument holder. The instrument interface is operated via a joystick control. An endoscope is applied to the instrument interface, which is tracked by a navigation system (Stealth, Medtronic, USA). RESULTS: The instrument holder was modified so that it could be applied in transsphenoidal surgery. Furthermore, translation and pivoting movements of the system were implemented, also a quick change between microscope and robotic-controlled endoscope was made possible. After extensive phantom testing two patients with large invasive pituitary adenomas were operated on using the robotic endoscope assistance during transsphenoidal surgery. The robotic assistance allowed the use of two additional instruments under endoscopic view. For example, drilling, suctioning, application of punches, as well as microsurgical tumor removal could be performed under endoscopic view. CONCLUSION: A robotic system could be adapted for use in endoscope-assisted transsphenoidal skull base surgery allowing simultaneous use of two instruments under endoscopic view. This opens new possibilities to extend transsphenoidal skull base surgery.
Authors: Vincent Trévillot; Rafael Sobral; Etienne Dombre; Philippe Poignet; Benoît Herman; Louis Crampette Journal: Int J Comput Assist Radiol Surg Date: 2013-04-09 Impact factor: 2.924
Authors: John S Schneider; Jessica Burgner; Robert J Webster; Paul T Russell Journal: Curr Opin Otolaryngol Head Neck Surg Date: 2013-02 Impact factor: 2.064
Authors: Jessica Burgner; D Caleb Rucker; Hunter B Gilbert; Philip J Swaney; Paul T Russell; Kyle D Weaver; Robert J Webster Journal: IEEE ASME Trans Mechatron Date: 2013-06-19 Impact factor: 5.303
Authors: Victor F Muñoz; Isabel Garcia-Morales; Juan Carlos Fraile-Marinero; Javier Perez-Turiel; Alvaro Muñoz-Garcia; Enrique Bauzano; Irene Rivas-Blanco; Jose María Sabater-Navarro; Eusebio de la Fuente Journal: Sensors (Basel) Date: 2021-03-26 Impact factor: 3.576
Authors: Miriam H A Bopp; Benjamin Saß; Mirza Pojskić; Felix Corr; Dustin Grimm; André Kemmling; Christopher Nimsky Journal: J Clin Med Date: 2022-09-23 Impact factor: 4.964