Faculty of Medicine, Health and Human Sciences, Macquarie University.
Department of Otolaryngology - Head and Neck Surgery, Royal Prince Alfred Hospital.
Curr Opin Otolaryngol Head Neck Surg. 2021 Feb 1;29(1):44-52. doi: 10.1097/MOO.0000000000000683.
The application of robotic surgery to anterior skull base disease has yet to be defined despite the potential for improved tumour resection with less morbidity in this region. Complex anatomy and restricted access have limited the development of robotic anterior skull base surgery.
A limited number of transoral robotic surgical anterior skull base procedures have been undertaken; however, there are significant limitations to the utilization of this technology in the anterior skull base. In this article, the advantages, disadvantages and limitations of robotic anterior skull base surgery are discussed. Currently, the major limitation is the size of the robotic endoscope and of the available instrumentation. Technological advancements that provide promise for the future development of robotic anterior skull base surgery are in development, such as single-port robots, flexible instrument systems and miniaturization and growth of minimally invasive platforms.
Although transnasal access to the skull base is not possible with the currently available robotic systems, promising technology does exist and is in development. Robotic anterior skull base surgery promises to provide greater access to skull base disease, improve oncologic results, reduce morbidity and to reduce the ergonomic burden on the surgeon.
尽管机器人手术在该区域具有减少发病率和提高肿瘤切除率的潜力，但在颅前底疾病中的应用尚未得到明确。复杂的解剖结构和有限的进入途径限制了机器人颅前底手术的发展。
已经进行了少量经口机器人颅前底手术；然而，这项技术在前颅底的应用存在很大的局限性。本文讨论了机器人颅前底手术的优缺点和局限性。目前，主要的限制是机器人内窥镜和可用器械的尺寸。为了未来发展机器人颅前底手术，正在开发一些有前途的技术进步，如单端口机器人、柔性器械系统以及微创平台的小型化和增长。
尽管目前的机器人系统无法经鼻进入颅底，但确实存在有前途的技术，并且正在开发中。机器人颅前底手术有望为颅底疾病提供更大的治疗途径，改善肿瘤学结果，降低发病率，并减轻外科医生的人体工程学负担。
