Applicability of a Dexterity-Enhancing Handheld Robot for 360° Endoscopic Skull Base Approaches: An Exploratory Cadaver Study

作者：Joachim Starup‐Hansen, Dan Zimelewicz Oberman, John Hanrahan, Emmanouil Dimitrakakis, Hani J. Marcus, João Paulo Almeida · 发表于：Operative Neurosurgery · 年份：2025 · DOI：10.1227/ons.0000000000001582 · 被引用次数：4 · 研究领域：Soft Robotics and Applications、Head and Neck Surgical Oncology、Surgical Simulation and Training

BACKGROUND AND OBJECTIVES: Endoscopic skull base surgery aims to reduce surgical morbidity by minimizing tissue manipulation and exposure. However, the anatomic constraints posed by the narrow surgical corridors and constrained operative workspace present technical challenges due to reduced dexterity. This study evaluates the applicability of a novel dexterity-enhancing handheld robot for endoscopic skull base approaches. METHODS: The robotic system is comprised of interchangeable articulated end-effectors coupled to a handheld controller. Two attending skull base neurosurgeons and 2 neurosurgery residents performed 8 skull base approaches on cadaveric specimens, spanning anterior, anterolateral, lateral, posterolateral, and posterior approaches. Conventional instruments were used to expose anatomic landmarks, followed by intraoperative tasks using the handheld robot. Participants were interviewed during the procedures to assess the robot's feasibility (ability to safely reach and perform its objective of manipulating tissue at the operative site) and usefulness (ability to perform desired objectives well). RESULTS: The handheld robotic system was tested across 8 endoscopic skull base approaches, achieving feasibility in all cases. Superior workspace reach compared with standard instruments was demonstrated in 6 of 8 approaches. Tissue manipulation was satisfactory in all approaches. All surgeons reported that the current or a future device prototype could be useful across al...