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Applicability of a Dexterity-Enhancing Handheld Robot for 360° Endoscopic Skull Base Approaches: An Exploratory
Joachim Starup-Hansen1,2, Dan Zimelewicz Oberman3, John G Hanrahan1,2
1Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London , UK.
Operative Neurosurgery (Hagerstown, Md.)
|April 28, 2025
Summary
A novel handheld robot enhanced dexterity in endoscopic skull base surgery, proving feasible across 8 approaches. Surgeons found the robotic system useful, particularly for expanded workspace reach, though design improvements are needed for certain transcranial procedures.
Area of Science:
- Neurosurgery
- Medical Robotics
- Surgical Technology
Background:
- Endoscopic skull base surgery minimizes morbidity but faces dexterity challenges due to narrow corridors.
- Limited workspace and instrument maneuverability hinder complex procedures.
Purpose of the Study:
- To evaluate the applicability and usefulness of a novel dexterity-enhancing handheld robot in endoscopic skull base surgery.
- To assess the robot's feasibility in performing intraoperative tasks and manipulating tissue.
Main Methods:
- Eight endoscopic skull base approaches were performed on cadaveric specimens by neurosurgeons and residents.
- A handheld robotic system with articulated end-effectors was used for intraoperative tasks after conventional instrument use.
- Surgeons' feedback was collected on the robot's feasibility and usefulness during procedures.
Main Results:
- The handheld robotic system was feasible in all 8 tested endoscopic skull base approaches.
- Superior workspace reach was observed in 6 of 8 approaches, with satisfactory tissue manipulation.
- Surgeons reported potential usefulness across all approaches, citing expanded workspace as a key advantage, but noted limitations in transcranial approaches.
Conclusions:
- The handheld robotic system shows applicability in endoscopic skull base surgery, enhancing dexterity and workspace.
- Iterative development is necessary to optimize instrument design, particularly for transcranial approaches, to fully realize the potential of robotic assistance.
