Lee John Y K, Bhowmick Deb A, Eun Daniel D, Welch William C
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Neurol Surg A Cent Eur Neurosurg. 2013 Jul;74(4):258-61. doi: 10.1055/s-0032-1330121. Epub 2013 Jan 11.
Minimally invasive techniques in spine surgery have gained significant popularity due to decreased tissue dissection and destruction, postoperative pain, and hospital stay. The laparoscopic anterior lumbar interbody fusion (ALIF), an innovation in minimally invasive spine surgery, is rarely done because it has marginal benefit over the mini-open ALIF technique in rates of retrograde ejaculation and vascular complications. We propose these outcomes can be improved with enhanced robotic-assisted dissection and exposure for ALIF.
Two patients with single-level degenerative spine disease at L5-S1, associated with mechanical back pain, underwent anterior spinal exposure using the da Vinci S Surgical Robot during ALIF.
In this report, we provide the first description of the use of a surgical robot in the dissection and exposure for ALIF in patients with degenerative spine disease. We demonstrate successful use of the da Vinci Surgical Robot in separating the presacral nervous plexus from retroperitoneal structures without postoperative vascular or urological complications over a 1-year follow-up period.
Use of the robotic assistance in the performance of ALIF is possible without significant operative complications. This technique may provide added benefit over conventional laparoscopic approaches to the spine.
脊柱手术中的微创技术因减少组织分离与破坏、术后疼痛及住院时间而广受欢迎。腹腔镜下前路腰椎椎间融合术（ALIF）作为微创脊柱手术的一项创新，实施较少，因为在逆行射精率和血管并发症方面，它与mini - open ALIF技术相比优势不明显。我们认为，通过增强机器人辅助的ALIF分离和暴露操作，这些结果可以得到改善。
两名L5 - S1单节段退行性脊柱疾病伴机械性背痛的患者，在ALIF手术期间使用da Vinci S手术机器人进行了前路脊柱暴露。
在本报告中，我们首次描述了手术机器人在退行性脊柱疾病患者的ALIF分离和暴露中的应用。我们展示了da Vinci手术机器人在1年随访期内成功地将骶前神经丛与腹膜后结构分离，且无术后血管或泌尿系统并发症。
在ALIF手术中使用机器人辅助是可行的，且无明显手术并发症。该技术可能比传统的腹腔镜脊柱手术方法具有更多优势。
