Abstract
Objectives To describe the potential uses of computed tomography image guidance in concert with
the surgical robot for skull base surgery.
Design An anatomical study was conducted.
Setting Tertiary academic center.
Participants Cadaveric skull.
Main Outcome Measures The primary outcome measure was to measure the accuracy of robotic arm positioning
to anatomical landmarks on a skull using image guidance and the surgical robot synchronously.
Instruments with different angles of rotations were used. Estimated systematic error
was calculated and compared with achieved errors. Clinical applications of metachronous
image guidance and robotic system were discussed.
Results The skull model approximated < 1 mm accuracy using standard image guidance instruments
and the 0-degree robotic arm positioning. Increased angles of instruments from 20
to 60 degrees on the robotic system revealed more significant increases in error than
estimated.
Conclusions Image guidance may be useful for transoral robotic approaches. Precise movements
are improved by limiting the angle of deviation. Future studies will help optimize
the combined technologies before validating the study in clinical settings.
Keywords
image guidance - robotic surgery - transoral robotic surgery - skull base
