Department of Neurosurgery, Taksim Research and Training Hospital, Istanbul, Turkey.
Department of Neurosurgery, Health Sciences University, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey.
World Neurosurg. 2020 Dec;144:e40-e52. doi: 10.1016/j.wneu.2020.07.153. Epub 2020 Jul 27.
Robotic surgical systems are used worldwide in various fields. In this study, we present the advantages and disadvantages of the most common robotic surgical system, the da Vinci Xi system, in the supracerebellar transtentorial approach to the mesial temporal region and discuss options for its integration into neurosurgery.
Our study was conducted at the Advanced Simulation and Applied Endoscopic Surgery Training and Research Center and Anatomy Laboratory. Four formalin-fixed human cadaveric head specimens with red silicone dye injected into their arterial structures and blue silicone dye injected into their venous structures were used in the study. Dissections were performed in microscopic and robotic stages. All phases were photographed using a three-dimensional photographic technique.
The mesial temporal lobe could be accessed via the supracerebellar transtentorial route with the use of the robotic system. We show that the robotic system can be used in difficult approaches and narrow regions with a wider exposure and superior image quality than with the microscopic approach, improving the ergonomics for the surgeon. The shortcomings of robotic systems are examined and innovative solutions are offered.
This study shows the advantages and disadvantages of the robotic surgical approach to the mesial temporal region via the supracerebellar transtentorial route. Robotic surgical systems can play a major role in neurosurgical practices with the tools designed and the innovative solutions determined in this study. Nevertheless, further research and development of these systems and related instruments are necessary to ensure their wider implementation in neurosurgery.
机器人手术系统在世界范围内广泛应用于各个领域。本研究旨在介绍最常见的机器人手术系统达芬奇 Xi 系统在幕上经小脑幕入路至颞叶内侧区域的优缺点，并探讨将其整合到神经外科中的选择。
我们的研究在高级模拟与应用内窥镜手术培训与研究中心和解剖实验室进行。本研究使用了 4 个福尔马林固定的人体头颅标本，其动脉结构内注入红色硅胶染料，静脉结构内注入蓝色硅胶染料。在显微镜和机器人阶段进行解剖。所有阶段均使用三维摄影技术进行拍照。
通过使用机器人系统，可以经小脑幕上入路到达颞叶内侧。我们展示了机器人系统可以用于困难入路和狭窄区域，提供比显微镜入路更广泛的暴露和更高质量的图像，从而改善手术医生的操作舒适度。同时，我们还检查了机器人系统的缺点并提出了创新性的解决方案。
本研究展示了通过幕上经小脑幕入路到达颞叶内侧的机器人手术方法的优缺点。机器人手术系统可以在神经外科实践中发挥重要作用，本研究中设计的工具和创新性解决方案为此提供了支持。然而，为了确保这些系统及其相关器械在神经外科中的更广泛应用，还需要进一步的研究和开发。
