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da Vinci robot-assisted keyhole neurosurgery: a cadaver study on feasibility and safety

Title: da Vinci robot-assisted keyhole neurosurgery: a cadaver study on feasibility and safety
Authors: Marcus, HJ
Hughes-Hallett, A
Cundy, TP
Yang, GZ
Darzi, A
Nandi, D
Item Type: Journal Article
Abstract: The goal of this cadaver study was to evaluate the feasibility and safety of da Vinci robot-assisted keyhole neurosurgery. Several keyhole craniotomies were fashioned including supraorbital subfrontal, retrosigmoid and supracerebellar infratentorial. In each case, a simple durotomy was performed, and the flap was retracted. The da Vinci surgical system was then used to perform arachnoid dissection towards the deep-seated intracranial cisterns. It was not possible to simultaneously pass the 12-mm endoscope and instruments through the keyhole craniotomy in any of the approaches performed, limiting visualization. The articulated instruments provided greater dexterity than existing tools, but the instrument arms could not be placed in parallel through the keyhole craniotomy and, therefore, could not be advanced to the deep cisterns without significant clashing. The da Vinci console offered considerable ergonomic advantages over the existing operating room arrangement, allowing the operating surgeon to remain non-sterile and seated comfortably throughout the procedure. However, the lack of haptic feedback was a notable limitation. In conclusion, while robotic platforms have the potential to greatly enhance the performance of transcranial approaches, there is strong justification for research into next-generation robots, better suited to keyhole neurosurgery.
Issue Date: 18-Dec-2014
Date of Acceptance: 10-Oct-2014
URI: http://hdl.handle.net/10044/1/44599
DOI: http://dx.doi.org/10.1007/s10143-014-0602-2
ISSN: 1437-2320
Publisher: Springer Verlag
Start Page: 367
End Page: 371
Journal / Book Title: Neurosurgical Review
Volume: 38
Issue: 2
Copyright Statement: © 2014 The Authors. This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
Sponsor/Funder: National Institute for Health Research
Funder's Grant Number: NF-SI-0510-10186
Keywords: Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Surgery
Neurosciences & Neurology
Image guided intervention
Minimally invasive surgery
Neurosurgery
Robotic surgery
TRANSORAL ODONTOIDECTOMY
PROSTATECTOMY
Cadaver
Craniotomy
Humans
Neurosurgical Procedures
Robotic Surgical Procedures
Robotics
Surgery, Computer-Assisted
Neurology & Neurosurgery
1103 Clinical Sciences
1109 Neurosciences
Appears in Collections:Faculty of Engineering
Division of Surgery
Computing
Department of Medicine
Faculty of Medicine



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