The Use of Teleoperated Concentric Tube Robots for Transsphenoidal Parasellar Surgery

Introduction: Access to the anterior skull base via transsphenoidal routes is employed for a multitude of pathologic entities, the most common being for pituitary disorders. The rise of endoscopy has offered significant advantages over the classical sublabial route. However, significant limitations remain due the largely rigid coaxial constraints of currently available systems. This often prevents access to peripherally located pathology. Similarly, the advent of robotics offers a number of intraoperative advantages such as force and speed scaling, as well as segmentation of pathology on imaging to allow a volumetrically constrained workspace. Again, the size of the currently commercially available robotic actuators is too large and rigid to function via most minimally invasive skull base approaches. We present a new paradigm for robotic anterior skull base surgery.