The Voice-Controlled Robotic Assist Scope Holder AESOP for the Endoscopic Approach to the Sella

摘要

OBJECTIVE: To evaluate the feasibility of using a voice-controlled robot Automated Endoscopic System for Optimal Positioning (AESOP) for holding and maneuvering the endoscope in the trans-sphenoidal approach to the pituitary. DESIGN: To compare the manual approach to the voice-activated robotic scope holder in maneuvering the endoscope and resecting pituitary lesions using a two-handed technique. SETTING: Robotic laboratory at Louisiana State University Health Sciences Center, Shreveport. CADAVERS: Ten fresh cadaver heads. MAIN OUTCOME MEASURES: To determine the feasibility, advantages, and disadvantages of a single neurosurgeon maneuvering the endoscope, visualizing key anatomical features in the sphenoid, and resecting skull base lesions after the approach by an otolaryngologist. RESULTS: The learning curve for utilization of the voice-controlled robotic arm was short. The compact cart with the AESOP took up little space and allowed the standard setup for this procedure. The elimination of the need for manual stabilization of the endoscope permitted the use of both hands for the actual procedure. The elimination of the tremor inherent with holding the endoscope manually allowed the scope to be placed closer to the target organ with fewer collisions. The most significant advantage was the ability of AESOP to save three anatomical positions, which could be returned to with a single voice command. CONCLUSIONS: Recently, the endoscopic-endonasal approach to the sella has gained popularity. The voice-activated robotic scope holder is safe and has several advantages over current scope holders. Its utility may reduce operating time and eliminate the need for a second surgeon to hold the endoscope.