Robotic Minimally Invasive Surgery for Frontal Convexity Meningioma: A Case Report and Technical Note

Minimally invasive robotic-assisted cranial neurosurgery represents an evolving paradigm in the surgical management of intracranial tumors. The integration of robotic exoscopic platforms into neurosurgical workflows has demonstrated potential benefits in operative ergonomics, visualization, and microsurgical precision. Frontal convexity meningiomas, among the most common supratentorial extra-axial neoplasms, may represent an ideal candidate lesion for this approach given their superficial location and well-defined arachnoid planes. We present the case of a 23-year-old man who presented after a sports-related head injury complicated by loss of consciousness and a generalized tonic-clonic seizure. Neuroimaging revealed a well-circumscribed, homogeneously enhancing left frontal convexity lesion measuring 2.50 × 3.0 cm, with perilesional edema and a dural tail, consistent with meningioma. A neuronavigation-guided robot-assisted minimally invasive craniotomy was performed using the RoboticScope exoscope (BHS Technologies, Innsbruck, Austria) through a 4 cm incision and a 3 cm diameter craniotomy. Microsurgical subarachnoid dissection enabled circumferential tumor delineation with preservation of cortical anatomy and superior sagittal sinus venous drainage, achieving Simpson grade I gross total resection. Histopathology confirmed World Health Organization (WHO) grade I fibrous meningioma. This case demonstrates that robot-assisted minimally invasive craniotomy using a robotic exoscope system is a safe and effective approach for frontal convexity meningiomas, offering enhanced visualization, reduced brain retraction, and favorable surgical outcomes. Further prospective studies are warranted to establish standardized protocols for robotic exoscopic platforms in minimally invasive cranial neurosurgery.