SYSTEMATIC REVIEW


Surgical Robotic Technology for Developing an Endonasal Endoscopic Transsphenoidal Surgery (EETS) Robotic System



Sorayouth Chumnanvej1, Branesh M. Pillai2, Jackrit Suthakorn2, *
1 Neurosurgery Division, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
2 Center for Biomedical and Robotics Technology (BART LAB) Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Salaya, Thailand


© 2019 Chumnanvej et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Center for Biomedical and Robotics Technology (BART LAB), Department of Biomedical Engineering, Faculty of Engineering, Mahidol University, Salaya, Thailand; ORCID id: - 0000-0003-1333-3982; Tel: +662-441-4255; Fax: +662-441-4254;
E-mails: jackrit@bartlab.org, jackrit.sut@mahidol.ac.th


Abstract

Purpose:

Neurosurgical robots are acknowledged for their advantages in assisting neurosurgeons in enhancing their precision and accuracy. Here, the aim of this study is to report the first use as a robot-assisted Endonasal Endoscopic Transsphenoidal (EET) approach, applied to reach sphenoid sinus in a cadaver. The introduction of the seven tenets for the Endonasal Endoscopic Transsphenoidal approach will propel the feasibility of neurosurgical techniques and instruments for intrasellar lesions.

Methods:

Endonasal endoscopic transsphenoidal approach in a cadaver was performed under robot assistance with simple navigation system. This preliminary study reveals the accuracy and precision of the robot to reach a target at sphenoid sinus safely and within the shortest duration .

Results:

This robotic technology provided the foundation to support neurosurgeons when they are working in narrow and complicated surgical corridors with accuracy and precision.

Conclusion:

This article reveals the first robot-assisted Endonasal Endoscopic Transsphenoidal approach. This demonstrates the feasibility of the evolution and will augment neurosurgeons toward their limits of minimally invasive surgical techniques, manual dexterity, and spatial orientation. These tenets will be as state of the art and overcome the future challenges of Endonasal Endoscopic Transsphenoidal approach shortly.

Keywords: Endoscopic Endonasal Transphenoid (EET), Medical robotics, Minimally invasive surgery, Neurosurgical robots, Pituitary adenoma, Robotic surgery.