While full integration of robotic surgery has been achieved in other surgical domains, its transition into neurosurgery has been more prolonged, especially with respect to pituitary surgery. The confined working space and precise maneuvers required in endoscopic endonasal surgery makes development of an efficacious and safe robotic system difficult. Nevertheless, preclinical studies have attempted to demonstrate the feasibility of the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) in both transnasal and transoral approaches. In addition, unique robotics such as the concentric tube robot have been created. This system is optimized specifically for anterior skull base surgery with smaller shaft diameter arms and improved maneuverability in tight corridors. The possible role of concentric tube robotics surgery in skull base pathologies has been explored, and the novel use of telesurgery incorporated into robotic neurosurgery is discussed. An endoscopic endonasal transsphenoidal surgical system has also been developed, integrating computational methods to create a presurgical reconstructive model for surgical planning and automating the line of dissection for an enhanced approach to the sphenoid sinus. While surgical robotics for transsphenoidal surgery remain in its nascency, these preliminary findings are promising and suggest a role for robotic pituitary surgery.

中文翻译：

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使用机器人接近蝶鞍的经蝶骨手术：综合使用人工智能、逼真的运动跟踪和远程手术

虽然机器人手术已经在其他外科领域实现了全面整合，但其向神经外科的过渡时间更长，尤其是在垂体手术方面。内窥镜鼻内手术所需的有限工作空间和精确操作使得开发有效且安全的机器人系统变得困难。然而，临床前研究试图证明达芬奇手术系统（Intuitive Surgical，Sunnyvale，CA）在经鼻和经口方法中的可行性。此外，还创造了独特的机器人技术，例如同心管机器人。该系统专门针对前颅底手术进行了优化，具有较小的轴直径臂和改进的狭窄通道中的可操作性。探讨了同心管机器人手术在颅底病变中的可能作用，并讨论了远程手术在机器人神经外科手术中的新用途。还开发了内窥镜鼻内经蝶窦手术系统，整合了计算方法，以创建用于手术计划的术前重建模型，并自动化解剖线以增强蝶窦入路。虽然用于经蝶窦手术的手术机器人仍处于起步阶段，但这些初步发现很有希望，并表明机器人垂体手术的作用。整合计算方法以创建用于手术计划的术前重建模型，并自动化解剖线以增强蝶窦入路。虽然用于经蝶窦手术的手术机器人仍处于起步阶段，但这些初步发现很有希望，并表明机器人垂体手术的作用。整合计算方法以创建用于手术计划的术前重建模型，并自动化解剖线以增强蝶窦入路。虽然用于经蝶窦手术的手术机器人仍处于起步阶段，但这些初步发现很有希望，并表明机器人垂体手术的作用。