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Minim Invasive Neurosurg 2004; 47(1): 41-46
DOI: 10.1055/s-2003-812465
Original Article
© Georg Thieme Verlag Stuttgart · New York

Adaptation of a Hexapod-Based Robotic System for Extended Endoscope-Assisted Transsphenoidal Skull Base Surgery

Ch.   Nimsky1 , J.  Rachinger1 , H.  Iro2 , R.  Fahlbusch1
  • 1Department of Neurosurgery, University Erlangen-Nürnberg, Erlangen, Germany
  • 2Department of ENT, University Erlangen-Nürnberg, Erlangen, Germany
Further Information

Publication History

Publication Date:
20 April 2004 (online)

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Abstract

Objective: To adapt a hexapod-based robotic system for use in extended endoscope-assisted transsphenoidal skull base surgery.

Methods: A robotic system (Evolution 1, Universal Robot Systems, Schwerin, Germany) based on a hexapod design with an attached seventh axis is used as instrument holder. The instrument interface is operated via a joystick control. An endoscope is applied to the instrument interface, which is tracked by a navigation system (Stealth, Medtronic, USA).

Results: The instrument holder was modified so that it could be applied in transsphenoidal surgery. Furthermore, translation and pivoting movements of the system were implemented, also a quick change between microscope and robotic-controlled endoscope was made possible. After extensive phantom testing two patients with large invasive pituitary adenomas were operated on using the robotic endoscope assistance during transsphenoidal surgery. The robotic assistance allowed the use of two additional instruments under endoscopic view. For example, drilling, suctioning, application of punches, as well as microsurgical tumor removal could be performed under endoscopic view.

Conclusion: A robotic system could be adapted for use in endoscope-assisted transsphenoidal skull base surgery allowing simultaneous use of two instruments under endoscopic view. This opens new possibilities to extend transsphenoidal skull base surgery.

Key words

Endoscope-assisted surgery - extended transsphenoidal surgery - hexapod robotic system - skull base surgery

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Priv.-Doz. Dr. Christopher Nimsky

Department of Neurosurgery · University Erlangen-Nürnberg

Schwabachanlage 6

91054 Erlangen

Germany

Phone: +49-9131-8534570

Fax: +49-9131-8534551

Email: nimsky@nch.imed.uni-erlangen.de

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