title: Interest of telemicrosurgery in peripheral nerve tumors: about a series of seven cases.
abstract: Surgery of the chronic peripheral nerve lesion should not only limit recurrence after excision, but it should also limit the sensory and motor sequelae. The aim of this work was to study the interest of telemicrosurgery to improve this result. Our series included 7 patients with peripheral nerve neuroma and tumors including two cases of hereditary neurofibromatosis. A Da Vinci S(®) robot equipped with microsurgical instruments was used for intraneural dissection. One case was performed with minimally invasive approach. At last follow-up, the pain decreased from 6/10 preoperatively to 3/10 postoperatively. The sensory deficit was stable except for two patients, whose sensory function was improved. No recurrence was noted. Telemicrosurgery seems to have two interests in the treatment of chronic peripheral nerve lesions: it reduces the size of incisions and increases the accuracy of surgery. These preliminary results suggest that surgical robots could play an essential role in microsurgery.
authors.affiliation: Department of neurosurgery, university hospital of Strasbourg, 10, avenue Baumann, 67403 Illkirch cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Tigan
authors.affiliation: Department of hand surgery, university hospital of Strasbourg, 10, avenue Baumann, 67403 Illkirch cedex, France; Department of orthopaedic surgery, university of Tokyo, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Miyamoto
authors.affiliation: Department of hand surgery, university hospital of Strasbourg, 10, avenue Baumann, 67403 Illkirch cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Hendriks
authors.affiliation: Department of hand surgery, university hospital of Strasbourg, 10, avenue Baumann, 67403 Illkirch cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Facca
authors.affiliation: Department of hand surgery, university hospital of Strasbourg, 10, avenue Baumann, 67403 Illkirch cedex, France. Electronic address: philippe.liverneaux@chru-strasbourg.fr.
authors.forename: P
authors.initials: P
authors.lastname: Liverneaux
mesh_terms: D000293:Adolescent; D000328:Adult; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D009455:Neurofibroma / Q000601:surgery*; D009463:Neuroma / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D010524:Peripheral Nervous System Neoplasms / Q000601:surgery*; D020127:Recovery of Function; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome
keywords: Dissection inter-fasciculaire; Interfascicular dissection; Neuroma; Névrome; Peripheral nerve tumor; Telemicrosurgery; Tumeur de nerf périphérique; Télémicrochirurgie