{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T09:07:04Z","timestamp":1779527224802,"version":"3.53.1"},"reference-count":58,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Despite its potential advantages, robotic surgery has yet to be applied to skull base procedures. Complex anatomy and restricted access have limited the development of robotic skull base surgery. The authors\u2019 aim was to conduct a feasibility study of robotic surgery for posterior fossa skull base lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Six silicone-injected postmortem human heads were prepared for the robotic surgery. Because there was no drilling tool with the robot, specimens were dissected in advance using an endoscope and microscope. The following approaches were investigated: 1) supracerebellar-infratentorial; 2) retromastoid; and 3) posterior occipitocervical junction surgeries. For each approach specific anatomical landmarks were identified, and the surgical freedom (vertical distance angle between the tools) was measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In the case of the supracerebellar-infratentorial approach, the authors used 3 burrs with 1.5 cm of diameter: 1 paramedian and 2 laterally. The view of the pineal region was visualized, and sufficient surgical freedom of both tools was secured. The median vertical distance was 1.2 cm (range 1.1\u20131.8 cm), and the median angle between the tools was 105\u00b0 (range 92\u00b0\u2013110\u00b0). On the other hand, in the retromastoid approach, with a single burr 2.5 cm in diameter, the root exit zone of the facial nerve was barely visible, and a space for tools to access was not secured. The median vertical distance was 0.8 cm (range 0.6\u20131.0 cm), and the median angle between the tools was 10\u00b0 (range 6\u00b0\u201312\u00b0). In the case of the posterior occipitocervical junction approach, the authors used the 3 tubular retractors, 1 in the middle and 2 laterally. Even though the space was narrow, the medulla and adjacent nerves could be identified, and a moderate level of surgical freedom could be obtained for tool mobilization. The median vertical distance was 1.6 cm (range 1.2\u20132.5 cm), and the median angle between the tools was 90\u00b0 (range 88\u00b0\u201395\u00b0).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Although robotic surgery has yet to be applied to neurosurgery, it is expected to be helpful in posterior fossa skull base surgery if appropriate tools can be developed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.9.focus24341","type":"journal-article","created":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T08:24:53Z","timestamp":1733041493000},"page":"E5","source":"Crossref","is-referenced-by-count":2,"title":["Feasibility of robotic posterior fossa skull base surgery"],"prefix":"10.3171","volume":"57","author":[{"given":"Min Ho","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California;"},{"name":"Department of Neurosurgery, Uijeongbu St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul, Korea;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California;"},{"name":"Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Rychen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano P.","family":"Rinaldi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Reza","family":"Arifianto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California;"},{"name":"Department of Neurosurgery, National Brain Center Hospital Prof. Dr. dr. Mahar Mardjono, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Vigo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C.","family":"Fernandez-Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"S3","key":"b1","series-title":"Int Forum Allergy Rhinol","first-page":"S145","article-title":"ICAR: endoscopic skull-base surgery","volume":"9","author":"Wang EW","year":"2019","unstructured":"Wang EW, Zanation AM, Gardner PA,  ICAR: endoscopic skull-base surgery. Int Forum Allergy Rhinol. 2019;9(S3):S145\u2013S365."},{"issue":"10","key":"b2","series-title":"Childs Nerv Syst","first-page":"2729","article-title":"Neuroendoscopy: history, endoscopes, and instrumentation","volume":"39","author":"Schroeder HWS","year":"2023","unstructured":"Schroeder HWS, Sgouros S. Neuroendoscopy: history, endoscopes, and instrumentation. Childs Nerv Syst. 2023;39(10):2729\u20132735."},{"issue":"5","key":"b3","series-title":"Neurosurgery","first-page":"1043","article-title":"Endoscopy and transsphenoidal surgery","volume":"54","author":"Cappabianca P","year":"2004","unstructured":"Cappabianca P, de Divitiis E. Endoscopy and transsphenoidal surgery. Neurosurgery. 2004;54(5):1043\u20131050."},{"issue":"1","key":"b4","series-title":"Neurochirurgie","first-page":"21","article-title":"Posterior fossa endoscopic-assisted surgery: a systematization of its surgical corridors","volume":"68","author":"Ries Centeno T","year":"2022","unstructured":"Ries Centeno T, Villamil F, Marco Del Pont F, Giovannini S, Caffaratti G, Cervio A. Posterior fossa endoscopic-assisted surgery: a systematization of its surgical corridors. Neurochirurgie. 2022;68(1):21\u201328."},{"issue":"6","key":"b5","series-title":"J Neurosurg Sci","first-page":"658","article-title":"Minimally invasive endoscopic-assisted approaches to the posterior fossa","volume":"62","author":"Yang A","year":"2018","unstructured":"Yang A, Folzenlogen Z, Youssef AS. Minimally invasive endoscopic-assisted approaches to the posterior fossa. J Neurosurg Sci. 2018;62(6):658\u2013666."},{"issue":"16","key":"b6","series-title":"Sensors (Basel)","first-page":"7104","article-title":"Robotic surgery in urology: history from PROBOT\u00ae to HUGOTM","volume":"23","author":"Brassetti A","year":"2023","unstructured":"Brassetti A, Ragusa A, Tedesco F,  Robotic surgery in urology: history from PROBOT\u00ae to HUGOTM. Sensors (Basel). 2023;23(16):7104."},{"issue":"2","key":"b7","series-title":"J Robot Surg","first-page":"113","article-title":"A history of robots: from science fiction to surgical robotics","volume":"1","author":"Hockstein NG","year":"2007","unstructured":"Hockstein NG, Gourin CG, Faust RA, Terris DJ. A history of robots: from science fiction to surgical robotics. 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Clin Neurol Neurosurg. 2020;197:106152."},{"issue":"4","key":"b24","series-title":"Neurosurg Rev","first-page":"723","article-title":"Anatomical features of skull base and oral cavity: a pilot study to determine the accessibility of the sella by transoral robotic-assisted surgery","volume":"38","author":"Amelot A","year":"2015","unstructured":"Amelot A, Trunet S, Degos V,  Anatomical features of skull base and oral cavity: a pilot study to determine the accessibility of the sella by transoral robotic-assisted surgery. Neurosurg Rev. 2015;38(4):723\u2013730."},{"issue":"1","key":"b25","series-title":"Neurofunction","first-page":"28","article-title":"Robotic surgery for microvascular decompression in hemifacial spasm: a feasibility study","volume":"20","author":"Ji HK","year":"2024","unstructured":"Ji HK, Lee MH, Lee TK. Robotic surgery for microvascular decompression in hemifacial spasm: a feasibility study. 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