Extreme Lateral Lumbar Interbody Fusion Surgery with a Robot-Assisted System in a Swine Model

Area of Science:

• Neurosurgery
• Robotic Surgery
• Spinal Fusion

Background:

• Minimally invasive spinal surgery offers advantages over traditional open procedures.
• Extreme lateral lumbar interbody fusion (XLIF) is a key technique in minimally invasive spine surgery.
• The integration of robotic systems in XLIF is an evolving area of surgical innovation.

Purpose of the Study:

• To assess the technical feasibility and safety of the Da Vinci Xi Surgical System for robot-assisted XLIF.
• To evaluate the procedural steps, operative time, and outcomes in a swine model.
• To determine the benefits of robotic assistance in protecting neurovascular structures during XLIF.

Main Methods:

• Robot-assisted endoscopic discectomy and XLIF cage insertion were performed in a swine model.
• Four ports were utilized for surgical access, including camera, bipolar forceps, and auxiliary ports.
• Operative time, procedural steps, and potential complications were meticulously recorded.

Main Results:

• The robot-assisted XLIF procedure was completed successfully with an operative time of 80 minutes.
• No intraoperative complications or instances of cage malposition were observed.
• Effective cage insertion and positioning were achieved using the robotic system and C-arm fluoroscopy.

Conclusions:

• Robot-assisted XLIF is a safe and technically feasible approach for lumbar interbody fusion.
• The Da Vinci Xi system facilitates protection of vital neurovascular structures during the procedure.
• High-quality imaging was maintained throughout the robot-assisted XLIF surgery, enhancing surgical visualization.