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Robotic Endoscopic Transnasal Skull Base Surgery in Clinical Practice: A Systematic Literature Review

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Robotics in Skull-Base Surgery

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Abstract

Background: The increasing complexity of transnasal endoscopic skull base surgery has led to a significant increase in operating times and, therefore, to the demand for an endoscope holder. A robotic endoscope holder might provide various advantages in transnasal endoscopic skull base surgery, but only recently the first clinical evaluations of robotic systems have been published.

Objective: A systematic review of the literature was performed to provide a comprehensive critical overview of robotic systems developed for transnasal endoscopic skull base surgery and evaluated in a clinical setting.

Methods: A systematic review was performed on PubMed and Scopus databases, using different keywords. The retrieved papers were analyzed, recording the following features: name of the robotic system, function of the robotic system, number of treated patients, and key findings.

Results: Clinical studies included in the review were divided into the following categories: transoral robotic skull base surgery with free-hand endoscopic transnasal approach; robotic armrest (iArms); robotic endoscope holders (ENDOFIXexo; Endoscope Robot®). Each category has specific advantages and limitations. Clinical experiences are increasingly reported but they still remain limited.

Conclusions: A few clinical applications of robotic endoscopic skull base surgery have been described. To improve the present results, the need for close collaboration with the industry and engineering research centers is evident and of paramount importance for future developments.

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References

  1. Cote DJ, Ruzevick J, Strickland BA, Zada G. Commentary: hybrid robotics for endoscopic Transnasal Skull Base surgery: single-Centre case series. Oper Neurosurg. 2021;21(6):E471

    Google Scholar 

  2. Doglietto F, Prevedello DM, Jane JA, Han J, Laws ER. A brief history of endoscopic transsphenoidal surgery—from Philipp Bozzini to the first world congress of endoscopic Skull Base surgery. Neurosurg Focus. 2005;19(6):1–6.

    Article  Google Scholar 

  3. Castelnuovo P, Pistochini A, Locatelli D. Different surgical approaches to the sellar region: focusing on the “two nostrils four hands technique.” Rhinology 2006 44(1):2–7.

    Google Scholar 

  4. Bolzoni Villaret A, Doglietto F, Carobbio A, Schreiber A, Panni C, Piantoni E, et al. Robotic Transnasal endoscopic Skull Base surgery: systematic review of the literature and report of a novel prototype for a hybrid system (Brescia endoscope assistant robotic holder). World Neurosurg. 2017;105:875–83.

    Article  PubMed  Google Scholar 

  5. Madoglio A, Zappa F, Mattavelli D, Rampinelli V, Ferrari M, Schreiber A, et al. Robotics in endoscopic transnasal skull base surgery: Literature review and personal experience. In: Control systems design of bio-robotics and bio-mechatronics with advanced applications [Internet]. Elsevier; 2020 [cited 2021 Feb 7]. p. 221–244. Available from: https://linkinghub.elsevier.com/retrieve/pii/B9780128174630000083

  6. Chan JYK, Leung I, Navarro-Alarcon D, Lin W, Li P, Lee DLY, et al. Foot-controlled robotic-enabled endoscope holder for endoscopic sinus surgery: a cadaveric feasibility study. Laryngoscope. 2016;126(3):566–9.

    Article  PubMed  Google Scholar 

  7. Blanco RGF, Boahene K. Robotic-assisted skull base surgery: preclinical study. J Laparoendosc Adv Surg Tech A. 2013;23(9):776–82.

    Article  PubMed  Google Scholar 

  8. Pangal DJ, Cote DJ, Ruzevick J, Yarovinsky B, Kugener G, Wrobel B, et al. Robotic and robot-assisted skull base neurosurgery: systematic review of current applications and future directions. Neurosurg Focus. 2022;52(1):E15.

    Article  PubMed  Google Scholar 

  9. Nimsky C, Rachinger J, Iro H, Fahlbusch R. Adaptation of a hexapod-based robotic system for extended endoscope-assisted transsphenoidal skull base surgery. Minim Invasive Neurosurg MIN. 2004;47(1):41–6.

    Article  PubMed  Google Scholar 

  10. Madoglio A, Roca E, Tampalini F, Fontanella MM, Doglietto F. Robotics in Neuroendoscopy. In: Al-Salihi MM, Tubbs RS, Ayyad A, Goto T, Maarouf M, editors. Introduction to robotics in minimally invasive neurosurgery [internet]. Cham: Springer International Publishing; 2022[cited 2022 Aug 21]. p. 39–55. Available from: https://doi.org/10.1007/978-3-030-90862-1_4.

  11. Wurm J, Dannenmann T, Bohr C, Iro H, Bumm K. Increased safety in robotic paranasal sinus and skull base surgery with redundant navigation and automated registration. Int J Med Robot. 2005;1(3):42–8.

    Article  CAS  PubMed  Google Scholar 

  12. Wei X, Zhang Y, Ju F, Guo H, Chen B, Wu H. Design and analysis of a continuum robot for transnasal skull base surgery. Int J Med Robot [Internet]. 2021 Dec [cited 2022 Aug 15];17(6). Available from: https://onlinelibrary.wiley.com/doi/10.1002/rcs.2328

  13. Hintschich CA, Fischer R, Seebauer C, Schebesch KM, Bohr C, Kühnel T. A third hand to the surgeon: the use of an endoscope holding arm in endonasal sinus surgery and well beyond. Eur Arch Otorhinolaryngol. 2022;279(4):1891–8.

    Article  PubMed  Google Scholar 

  14. Zappa F, Madoglio A, Ferrari M, Mattavelli D, Schreiber A, Taboni S, et al. Hybrid robotics for endoscopic Transnasal Skull Base surgery: single-Centre case series. Oper Neurosurg. 2021;21(6):426–35.

    Article  Google Scholar 

  15. Mattheis S, Schlüter A, Stähr K, Holtmann L, Höing B, Hussain T, et al. First use of a new robotic endoscope guiding system in endoscopic orbital decompression. Ear Nose Throat J. 2021;100(5_suppl):443S–8S.

    Article  PubMed  Google Scholar 

  16. Moher D, Liberati A, Tetzlaff J, Altman DG, for the PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339(jul21 1):b2535.

    Google Scholar 

  17. Ogiwara T, Goto T, Nagm A, Hongo K. Endoscopic endonasal transsphenoidal surgery using the iArmS operation support robot: initial experience in 43 patients. Neurosurg Focus. 2017;42(5):E10.

    Article  PubMed  Google Scholar 

  18. Carrau RL, Prevedello DM, de Lara D, Durmus K, Ozer E. Combined transoral robotic surgery and endoscopic endonasal approach for the resection of extensive malignancies of the skull base: combined TORS and EEA for resection of extensive malignancies of Skull Base. Head Neck. 2013;35(11):E351–8.

    Article  PubMed  Google Scholar 

  19. Zappa F, Mattavelli D, Madoglio A, Rampinelli V, Ferrari M, Tampalini F, et al. Hybrid robotics for endoscopic Skull Base surgery: preclinical evaluation and surgeon first impression. World Neurosurg. 2020;134:e572–80.

    Article  PubMed  Google Scholar 

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Disclosure

The Authors declare no Conflict of Interest.

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Authors and Affiliations

  1. Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy

    Alba Madoglio & Pasquale De Bonis

  2. Department of Neurosurgery, Sant’ Anna University Hospital, Ferrara, Italy

    Alba Madoglio & Pasquale De Bonis

  3. Unit of Otorhinolaryngology-Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy

    Davide Mattavelli

  4. Section of Otorhinolaryngology - Head and Neck Surgery, Department of Neurosciences, University of Padua – “Azienda Ospedaliera di Padova”, Padua, Italy

    Marco Ferrari

  5. Istituto Ospedaliero Fondazione Poliambulanza, Head and Neck Department, Neurosurgery, Brescia, Italy

    Elena Roca

  6. Neurosurgery Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy

    Marco Maria Fontanella

  7. Neurosurgery, Department of Neurosciences, Organs and Thorax, Catholic University School of Medicine, Rome, Italy

    Francesco Doglietto

  8. Neurosurgery, Department of Neuroscience, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    Francesco Doglietto

Authors
  1. Alba Madoglio
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  2. Davide Mattavelli
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  3. Marco Ferrari
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  4. Elena Roca
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  5. Pasquale De Bonis
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  6. Marco Maria Fontanella
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  7. Francesco Doglietto
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Corresponding author

Correspondence to Francesco Doglietto .

Editor information

Editors and Affiliations

  1. Department of Neurological Surgery, School of Medicine and Public Health University of Wisconsin, Madison, WI, USA

    Mohammed Maan Al-Salihi

  2. Department of Neurosurgery, Hamad General Hospital, Doha, Qatar

    Ali Ayyad

  3. Department of Neurosurgery, Tulane University, New Orleans, LA, USA

    R. Shane Tubbs

  4. Department of Neurosurgery, Saarland University Hospital, Homburg, Germany

    Joachim Oertel

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Madoglio, A. et al. (2023). Robotic Endoscopic Transnasal Skull Base Surgery in Clinical Practice: A Systematic Literature Review. In: Al-Salihi, M.M., Ayyad, A., Tubbs, R.S., Oertel, J. (eds) Robotics in Skull-Base Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-38376-2_3

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  • DOI: https://doi.org/10.1007/978-3-031-38376-2_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-38375-5

  • Online ISBN: 978-3-031-38376-2

  • eBook Packages: MedicineMedicine (R0)

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