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Whole-Workflow Robotic-Assisted Percutaneous Endoscopic Lumbar Discectomy via a Two-Step Access Method: Technical
Wenjie Zheng1, Junlong Wu1,2, Wen Xia1
1Department of Orthopaedics, Xinqiao Hospital of Army Medical University, Chongqing, People's Republic of China.
Journal of Pain Research
|September 2, 2025
Summary
This study demonstrates that robotic assistance for Percutaneous Endoscopic Lumbar Discectomy (PELD) is safe and effective. The novel two-step workflow resulted in 100% patient satisfaction with no severe complications.
Area of Science:
- Spinal Surgery
- Robotics in Medicine
- Minimally Invasive Procedures
Background:
- Robotic systems offer precise surgical planning and real-time navigation.
- Exploration of robotic assistance in Percutaneous Endoscopic Lumbar Discectomy (PELD) is emerging.
- Previous studies focused mainly on robotic-assisted transforaminal puncture.
Purpose of the Study:
- To establish a two-step cannulation surgical workflow for whole-process robotic-assisted PELD.
- To evaluate the feasibility and safety of robotic-assisted PELD.
- To summarize the surgical workflow of robotic-assisted PELD.
Main Methods:
- 14 patients with lumbar disc herniations underwent robotic-assisted PELD.
- Preoperative CT images were used for surgical planning and registered in the navigation system.
- The procedure involved robotic guidance for puncture, dilation, foraminoplasty, and working tube placement.
Main Results:
- All 14 patients successfully completed the robotic-assisted PELD surgery.
- Mean operative time was 92.21±18.65 minutes with reduced intraoperative fluoroscopy shots (3.35±0.84).
- Significant improvements in pain scores (VAS, ODI) and 100% patient satisfaction were observed, with no severe complications.
Conclusions:
- Robotic assistance ensures precise planning and safe implementation of PELD.
- The specialized two-step access method simplifies PELD, enhancing safety and effectiveness.
- Robotic-assisted PELD reduces radiation exposure for both patients and surgeons.
