Transoral robotic surgery of craniocervical junction and atlantoaxial spine: A cadaveric study - Laboratory investigation

John Y K Lee, Bert W. O'Malley, Jason G. Newman, Gregory S. Weinstein, Bradley Lega, Jason Diaz, M. Sean Grady

Research output: Contribution to journalArticle

51 Scopus citations

Abstract

Object. The goal of this study was to determine the potential role and current limitations of the da Vinci surgical robot in transoral decompression of craniocervical junction (CCJ). Methods. The da Vinci Surgical System was used in 2 cadaver heads with neck and clavicles intact. Both neurosurgeons and otolaryngologists familiar with the open microscopic procedure, as well as the transoral robotic surgical procedure, undertook dissection and decompression of the CCJ. Results. The robotic system provided superb illumination and 3D depth perception even several centimeters deep to the posterior oropharyngeal mucosa. The 30° endoscope improved cephalad visualization, eliminating the need to split the soft palate for exposure of the lower clivus. The " intuitive" nature of the da Vinci surgical robot arms provided an advantage in allowing the ability to suture the dura mater in a deep, dark corridor. Because visualization was excellent, tremor-free closure was possible. Conclusions. The authors' findings suggest that transoral robotic surgery, with the da Vinci robot system, holds great potential for decompression of the CCJ as well as resection of both extra- and intradural tumors of this region. Further instrument development is necessary and continued investigation is warranted.

Original languageEnglish (US)
Pages (from-to)13-18
Number of pages6
JournalJournal of Neurosurgery: Spine
Volume12
Issue number1
DOIs
StatePublished - Jan 1 2010

Keywords

  • Craniocervical junction
  • Pannus
  • Robotic surgery
  • Transoral surgery

ASJC Scopus subject areas

  • Surgery
  • Neurology
  • Clinical Neurology

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