Combined robotic transorbital and transnasal approach to the nasopharynx and anterior skull base: Feasibility study

Faulkner, Jack; Naidoo, Reshania; Arora, Asit; Jeannon, Jean Pierre; Hopkins, Claire; Šurda, Pavol

doi:10.1111/coa.13550

Cited by 12 publications

(21 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Flexible endoscope that allows for greater maneuverability; modified midfacial degloving needed for access; haptic feedback preserved Versius (CMR Surgical) 26 approach and reported successful creation of a primary dural closure using sutures and a mucoperiosteal graft. 16,17 While the transmaxillary approach was the most well studied, multiple other port access points were used, including a transcervical route in which surgical arm ports were inserted behind the submandibular gland, a transorbital route where arm ports were inserted in bilateral medial orbits, and a completely transnasal route using an expanded nasal corridor.…”

Section: Sellar Regionmentioning

confidence: 99%

“…For this system, a bilateral transorbital approach for the surgical ports and a transnasal approach for the endoscope was used. 26 Finally, Chumnanvej et al developed their own custom prototype for a robotic EEA and used preoperative imaging, a QR code-based tracking technology, and intraoperative fluoroscopy for semiautomatic (neurosurgeonsupervised) robotic guidance of a surgical tool to reach the base of the sphenoid sinus. 27 The authors reported a robotic time-to-task completion of < 30 minutes for robotic setup and docking and < 2 minutes to task completion (reaching the sphenoid sinus).…”

Section: Alternatives To the Da Vinci Robotmentioning

confidence: 99%

See 1 more Smart Citation

Robotic and robot-assisted skull base neurosurgery: systematic review of current applications and future directions

Pangal

Coté

Ruzevick

et al. 2022

Neurosurgical Focus

View full text Add to dashboard Cite

OBJECTIVE The utility of robotic instrumentation is expanding in neurosurgery. Despite this, successful examples of robotic implementation for endoscopic endonasal or skull base neurosurgery remain limited. Therefore, the authors performed a systematic review of the literature to identify all articles that used robotic systems to access the sella or anterior, middle, or posterior cranial fossae. METHODS A systematic review of MEDLINE and PubMed in accordance with PRISMA guidelines performed for articles published between January 1, 1990, and August 1, 2021, was conducted to identify all robotic systems (autonomous, semiautonomous, or surgeon-controlled) used for skull base neurosurgical procedures. Cadaveric and human clinical studies were included. Studies with exclusively otorhinolaryngological applications or using robotic microscopes were excluded. RESULTS A total of 561 studies were identified from the initial search, of which 22 were included following full-text review. Transoral robotic surgery (TORS) using the da Vinci Surgical System was the most widely reported system (4 studies) utilized for skull base and pituitary fossa procedures; additionally, it has been reported for resection of sellar masses in 4 patients. Seven cadaveric studies used the da Vinci Surgical System to access the skull base using alternative, non–TORS approaches (e.g., transnasal, transmaxillary, and supraorbital). Five cadaveric studies investigated alternative systems to access the skull base. Six studies investigated the use of robotic endoscope holders. Advantages to robotic applications in skull base neurosurgery included improved lighting and 3D visualization, replication of more traditional gesture-based movements, and the ability for dexterous movements ordinarily constrained by small operative corridors. Limitations included the size and angulation capacity of the robot, lack of drilling components preventing fully robotic procedures, and cost. Robotic endoscope holders may have been particularly advantageous when the use of a surgical assistant or second surgeon was limited. CONCLUSIONS Robotic skull base neurosurgery has been growing in popularity and feasibility, but significant limitations remain. While robotic systems seem to have allowed for greater maneuverability and 3D visualization, their size and lack of neurosurgery-specific tools have continued to prevent widespread adoption into current practice. The next generation of robotic technologies should prioritize overcoming these limitations.

show abstract

Section: Sellar Regionmentioning

confidence: 99%

Section: Alternatives To the Da Vinci Robotmentioning

confidence: 99%

Robotic and robot-assisted skull base neurosurgery: systematic review of current applications and future directions

Pangal

Coté

Ruzevick

et al. 2022

Neurosurgical Focus

View full text Add to dashboard Cite

show abstract

“…The system has proved to be safe and effective in these applications. We have previously reported a feasibility cadaver study using the system to perform robotic access to the nasopharynx, skull base and brain via a combined transorbital and transnasal approach 6 . This is the first phase 0 (IDEAL‐D) evaluation of the Versius Surgical System in transoral surgery 14 …”

Section: Introductionmentioning

confidence: 99%

“…As a result, TORS has become a cornerstone of head and neck malignancy management. TORS was first developed for the management of early oropharyngeal malignancy but has expanded to multiple anatomical subsites and has expanding benign applications 3‐6 . The clear advantages of TORS have been embraced and robotic surgical systems will remain a crucial armament in the future treatment pathways.…”

Section: Introductionmentioning

confidence: 99%

“…TORS was first developed for the management of early oropharyngeal malignancy but has expanded to multiple anatomical subsites and has expanding benign applications. [3][4][5][6] The clear advantages of TORS have been embraced and robotic surgical systems will remain a crucial armament in the future treatment pathways. The primary robotic system currently available in the Da Vinci surgical platform (Intuitive Surgical Inc Sunnyvale, CA, USA).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Pre‐clinical evaluation of a novel robotic system for transoral robotic surgery

Faulkner

Arora

Swords

et al. 2021

Clinical Otolaryngology

Self Cite

View full text Add to dashboard Cite

show abstract

Transoral robotic resection of advanced recurrent nasopharyngeal carcinoma involving the internal carotid artery

Shi

Dai

Zhu

et al. 2022

Robotics Computer Surgery

View full text Add to dashboard Cite

Background: Transoral robotic surgery (TORS) is a reliable, minimally invasive approach for treating recurrent nasopharyngeal carcinoma (rNPC). However, tumours involving the internal carotid artery (ICA) are considered to be unsuitable for TORS. This paper presents the first case of transoral robotic resection of advanced rNPC involving the ICA. Materials and Methods:This case is a 55 year-old male patient who received radiotherapy 27 years ago. This patient underwent a standard TORS resection 2 weeks after ipsilateral ICA embolization.Results: Postoperative Magnetic resonance imaging and biopsy results indicated total resection. During the 2 month follow-up, no severe complications were found, and the primary site was tumour-free. Conclusion:This study preliminarily presents the feasibility and efficiency of advanced rNPC resection with TORS. TORS can potentially provide better quality of life for patients as a less invasive approach than current endoscopic surgery. Even so, the surgical approach should be selected strictly according to the tumour's location.

show abstract

Combined robotic transorbital and transnasal approach to the nasopharynx and anterior skull base: Feasibility study

Cited by 12 publications

References 11 publications

Robotic and robot-assisted skull base neurosurgery: systematic review of current applications and future directions

Robotic and robot-assisted skull base neurosurgery: systematic review of current applications and future directions

Pre‐clinical evaluation of a novel robotic system for transoral robotic surgery

Transoral robotic resection of advanced recurrent nasopharyngeal carcinoma involving the internal carotid artery

Contact Info

Product

Resources

About