Neurosurgical Robot-Assisted Navigation Enhances Precision in Bypass Surgery for Moyamoya Disease: A Study of Vascular Protection and Haemodynamic Optimization

IF 2.4 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2026-04-09 DOI:10.1002/rcs.70162

Hongwen Li, Suqin Zhang, Yang Li, Xiuhu An, Yunfei Song, Xinyu Yang, Yan Zhao

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引用次数: 0

Abstract

Background

Despite improvements in revascularisation, precise donor vessel localization and haemodynamic optimization remain critical challenges in moyamoya disease (MMD) bypass surgery, especially for patients with pre-existing extracranial-intracranial (EC-IC) collaterals. This study evaluates the feasibility of neurosurgical robot-assisted navigation in addressing these challenges.

Methods

Five consecutive MMD patients who received robot-assisted combined direct (STA-MCA) and indirect bypass from July to October 2023 were analysed retrospectively. Primary outcomes were intraoperative vessel injury rates and 12-month donor vessel patency on DSA/MRA.

Results

All STA dissections (5/5) succeeded without MMA injury. Postoperative imaging showed no competitive flow or donor vessel occlusion. All patients exhibited improved cognitive scores and favourable clinical outcomes at 1-year follow-up.

Conclusion

Robot-assisted navigation enhances surgical precision in MMD through: Preserving EC-IC collaterals via millimetre-level trajectory planning and optimising anastomosis geometry to prevent competitive flow, which is important for patients with existing collaterals.

查看原文本刊更多论文

神经外科机器人辅助导航提高烟雾病搭桥手术的精度：血管保护和血流动力学优化的研究。

背景：尽管血管重建有所改善，但在烟雾病（MMD）搭桥手术中，精确的供体血管定位和血流动力学优化仍然是关键的挑战，特别是对于已经存在颅外-颅内（EC-IC）侧支的患者。本研究评估了神经外科机器人辅助导航解决这些挑战的可行性。方法：回顾性分析2023年7月至10月连续5例接受机器人辅助联合直接（STA-MCA）和间接旁路治疗的烟雾病患者。主要结果是术中血管损伤率和DSA/MRA显示的12个月供体血管通畅度。结果：所有STA手术成功（5/5），无MMA损伤。术后影像学显示无竞争性血流或供血管阻塞。在1年的随访中，所有患者的认知评分均有所改善，临床结果良好。结论：机器人辅助导航通过以下方式提高了MMD手术精度：通过毫米级轨迹规划保存EC-IC侧支，优化吻合几何形状以防止竞争性血流，这对已有侧支的患者很重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.