Microvascular decompression in trigeminal neuralgia using a robot-assisted exoscope and head-mounted display

Area of Science:

• Neurosurgery
• Surgical Technology

Background:

• Microvascular decompression (MVD) for trigeminal neuralgia (TN) traditionally uses an operating microscope (OM).
• Emerging endoscopic and exoscopic techniques aim to enhance surgical ergonomics and visualization.

Purpose of the Study:

• To evaluate the initial clinical experience of MVD for TN using a novel robotic binocular exoscope with a head-mounted display (RoboticScope).

Main Methods:

• Nine patients with TN underwent MVD using the RoboticScope via a mini-retrosigmoid approach.
• Surgical parameters including timing, ergonomics, visualization, adverse events, and 1-month pain outcomes were assessed.

Main Results:

• All procedures were completed successfully with the RoboticScope, without conversion to OM.
• Surgeons reported improved comfort and visualization compared to OM.
• Surgical duration was significantly reduced (median 18 minutes with RoboticScope vs. 34 minutes with OM, p = 0.0001).
• No intraoperative adverse events were observed.

Conclusions:

• The RoboticScope enables safe and effective MVD for TN.
• This technology offers benefits of enhanced ergonomics, superior stereoscopic visualization, and shorter surgical times for surgeons.