1Department of Biomedical Sciences, Humanitas University; and.
2Neurosurgery Department, IRCCS Humanitas Research Hospital, Milan, Italy.
Neurosurg Focus. 2024 Dec 1;57(6):E9. doi: 10.3171/2024.9.FOCUS24373.
Microvascular decompression (MVD) in trigeminal neuralgia (TN) is currently managed using an operating microscope (OM). Recent experiences with endoscopy-assisted, fully endoscopic, and exoscopic surgery have been described, aiming to improve ergonomics and image quality. The aim of this study was to report the first series of patients operated on with the aid of a robotic binocular exoscope using a head-mounted display (RoboticScope).
From September 2023 to March 2024, 9 patients with TN were treated using the RoboticScope. A classic mini-retrosigmoid approach was performed and standard microsurgical techniques were applied. Surgical timing, ergonomics, visual performances, adverse events, and 1-month postoperative pain outcomes were evaluated.
All surgeries were completed without shifting to the OM. Surgeon comfort with the RoboticScope was better compared with the OM and visualization was good. No intraoperative adverse events were recorded. The duration of the procedure was significantly shorter with the RoboticScope compared to those using the OM (median 18 vs 34 minutes, p = 0.0001).
MVD can be safely and effectively performed using the RoboticScope. Surgeons benefit from better ergonomics, stereoscopic image quality, and shorter surgical duration.
目前，微血管减压术（MVD）治疗三叉神经痛（TN）采用手术显微镜（OM）进行管理。最近已经描述了内窥镜辅助、全内窥镜和外窥镜手术的相关经验，旨在改善手术的舒适度和图像质量。本研究旨在报告第一系列使用头戴式显示器的机器人双目外窥镜（RoboticScope）辅助下进行手术的患者。
从 2023 年 9 月至 2024 年 3 月，9 例 TN 患者接受了 RoboticScope 治疗。采用经典的迷你乙状窦后入路，应用标准的显微外科技术。评估手术时间、手术舒适度、视觉表现、不良事件以及术后 1 个月的疼痛结果。
所有手术均在未切换至 OM 的情况下完成。与 OM 相比，医生使用 RoboticScope 的舒适度更好，且可视化效果良好。术中未发生不良事件。与 OM 相比，RoboticScope 的手术时间明显缩短（中位数 18 分钟 vs 34 分钟，p = 0.0001）。
使用 RoboticScope 可以安全有效地进行 MVD。手术医生可以从更好的手术舒适度、立体图像质量和更短的手术时间中受益。
