Robotic endoscopic sinus and skull base surgery: review of the literature and future prospects

Objective: There has been a considerable growth in the indications of endonasal surgery that now include malignant tumours of the nasal fossae and anterior and middle cranial fossa. However, new limitations have also been identified, such as bleeding and cerebrospinal fluid leak, as well as the need to use several instruments simultaneously. Can robotics provide solutions to these problems?

Method: Review of the literature based on the three main databases: Medline, Pubmed and Cochrane.

Results: Ten publications were identified. Some authors have developed surgical approaches to the skull base using the da Vinci(®) robot, while others have designed specific robots.

Conclusion: None of the currently available solutions appears to be completely suitable. The da Vinci(®) robot is very cumbersome and can only be used in the middle cranial fossa via complex and relatively invasive routes. The other robots are laboratory prototypes. We are currently developing an innovative, compact, ergonomic and safe dedicated endoscope holder.