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Da Vinci robotic-assisted anterolateral lumbar arthrodesis: operative technique

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Abstract

Background

Minimally invasive approaches for lumbar fusion are aimed at reducing soft tissue injury in order to minimize surgical morbidity and facilitate recovery.

Method

Applied to oblique lateral lumbar interbody fusion (OLIF), Da Vinci® robot (DVR) assistance can help specially in obese patients. Positioning and important anatomical landmarks are reviewed. Indications, advantages, and limitations are discussed, and a step-by-step description of the procedure is presented. OLIF can be achieved efficiently through this approach with lesser blood loss, shorter hospital stays, and reduced rate of general complications.

Conclusion

The use of DVR assistance for OLIF is a promising new technique.

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Acknowledgements

We would like to thank Pr Litré for review, Dr Settembre for her participation in the surgery, Dr Albader for video’s comments, and Dr Mansouri for review, recruitment, and his participation in the surgery.

Author information

Authors and Affiliations

  1. Neurosurgery Department, CHU de Reims, 45 rue Cognacq Jay, 51100, Reims, France

    Stanislas Loniewski

  2. Neurosurgery Department, Hôpital de la Timone, Assistance Publique des Hôpitaux de Marseille, 264 rue Saint-Pierre, 13005, Marseille, France

    Kaissar Farah & Stéphane Fuentes

  3. Vascular Surgery Department, Hôpitaux de Brabois, CHRU Nancy, rue du Morvan, 54511, Vandœuvre-lès-Nancy, France

    Serguei Malikov

Authors
  1. Stanislas Loniewski
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  2. Kaissar Farah
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  3. Serguei Malikov
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  4. Stéphane Fuentes
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Corresponding author

Correspondence to Stanislas Loniewski.

Ethics declarations

Informed consent

Informed consent was not required because of anonymous and observational character of the analysis.

Conflict of interest

The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Additional information

Key points

1. Positioning of the patient in right lateral decubitus position

2. Fluoroscopic identification of the intervertebral disc

3. Insufflation of the peritoneum and insertion of the endoscope and the various arms of the DVR

4. Release of the left colonic angle and medial retraction of the sigmoid colon

5. Incision of the retroperitoneum from the left renal artery to the iliac bifurcation

6. Preoperative injected aorto-iliac scanner

7. Clipping and section of the lumbar branches

8. Retraction of the aorto-iliac vessels forward and the psoas posteriorly

9. Discectomy

10. Cage insertion under fluoroscopic control

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Loniewski, S., Farah, K., Malikov, S. et al. Da Vinci robotic-assisted anterolateral lumbar arthrodesis: operative technique. Acta Neurochir 165, 2711–2716 (2023). https://doi.org/10.1007/s00701-023-05676-6

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  • DOI: https://doi.org/10.1007/s00701-023-05676-6

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