Transoral robotic surgery of the central skull base: preclinical investigations

Abstract

In this study we explored possible applications of the da Vinci system in approaching the skull base at optic chiasm level on two cryopreserved cadavers, using an entirely transoral robotic technique (TORS). We used a standard 12 mm endoscopy and 8 mm terminals. Bone drilling was performed manually. The da Vinci system is equipped with very good illumination and 3D viewing, thus providing excellent vision and great maneuverability even in the less accessible areas of the skull. Our experience demonstrates that an entirely transoral skull base robotic approach to this complex anatomical region has many advantages as compared to traditional techniques.

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

“…A total of 4 studies used the da Vinci system with a transoral approach to access the sella turcica and the skull base (Table 1). [12][13][14][15] Two studies had a cadaveric component, serving as an initial proof-of-concept and feasibility study to determine the ability of TORS to access the sella turcica. 14,15 In all cases, a TORS approach permitted access to the sella, allowing for manipulation of the pituitary gland and optic chiasm.…”

“…[12][13][14][15] Two studies had a cadaveric component, serving as an initial proof-of-concept and feasibility study to determine the ability of TORS to access the sella turcica. 14,15 In all cases, a TORS approach permitted access to the sella, allowing for manipulation of the pituitary gland and optic chiasm. Authors described improved visualization and depth perception using a robotic approach compared with a traditional EEA.…”

Transoral robotic surgery advantages and disadvantages: a narrative review

“… Head and neck [2–22]: This category includes all publications about head and neck carcinomas and tumours and can be divided into four subcategories. The first is about the evaluation [2] and clinical cases [3] of the flex robotic system in TORS, which is a flexible robotic scope that allows the surgeon to access and visualise structures within the oropharynx, hypopharynx, and larynx.…”

“…The first is about the evaluation [2] and clinical cases [3] of the flex robotic system in TORS, which is a flexible robotic scope that allows the surgeon to access and visualise structures within the oropharynx, hypopharynx, and larynx. The second emphasises on feasibility and technical specs of the Da Vinci System [9–12] and some specific models of it such as the Da Vinci Xi [4–6], S [7, 8] or Si [8] system. The third subcategory includes publications for: clinical studies for head and neck cancer [13, 14, 16], the procedures for the patient selection in TORS [15], studies for postoperative haemorrhage and hospital revisit [18], TORS frontiers [17] and comparative outcomes of concurrent versus staged TORS [19].…”