title: Use of a micromanipulator system (NeuRobot) in endoscopic neurosurgery.
abstract: NeuRobot, a micromanipulator system with a rigid neuroendoscope and three micromanipulators, was developed for less invasive and telecontrolled neurosurgery. This system can be used to perform sophisticated surgical procedures through a small, 10-mm-diameter, window. The present study was performed to evaluate the feasibility of using NeuRobot in neuroendoscopy. Four different intraventricular neurosurgical procedures were simulated in three fixed cadaver heads using NeuRobot: (1) fenestration of the floor of the third ventricle; (2) fenestration of the septum pellucidum; (3) biopsy of the thalamus; and (4) biopsy of the choroid plexus of the lateral ventricle. Each procedure required less than 2 min, and all procedures were performed accurately. After these surgical simulations, a third ventriculostomy was carried out safely and adequately in a patient with obstructive hydrocephalus due to a midbrain venous angioma. Our results confirmed that NeuRobot is applicable to lesions in which conventional endoscopic neurosurgery is indicated. Furthermore, NeuRobot can perform more complex surgical procedures than a conventional neuroendoscope because of its maneuverability and stability. NeuRobot will become a useful neurosurgical tool for dealing with lesions that are difficult to treat by conventional neuroendoscopic surgery.
authors.affiliation: Department of Neurosurgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Takasuna
authors.forename: T
authors.initials: T
authors.lastname: Goto
authors.forename: Y
authors.initials: Y
authors.lastname: Kakizawa
authors.forename: T
authors.initials: T
authors.lastname: Miyahara
authors.forename: J
authors.initials: J
authors.lastname: Koyama
authors.forename: Y
authors.initials: Y
authors.lastname: Tanaka
authors.forename: T
authors.initials: T
authors.lastname: Kawai
authors.forename: K
authors.initials: K
authors.lastname: Hongo
mesh_terms: D001706:Biopsy / Q000379:methods; D002102:Cadaver; D020787:Central Nervous System Venous Angioma / Q000150:complications; D002831:Choroid Plexus / Q000473:pathology; D004724:Endoscopy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008846:Micromanipulation / Q000295:instrumentation*; D008875:Middle Aged; D044583:Neuroendoscopy; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D012371:Robotics; D020665:Septum of Brain / Q000601:surgery; D013788:Thalamus / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014696:Ventriculostomy / Q000295:instrumentation / Q000379:methods