Robotic surgery for microvascular decompression in hemifacial spasm: a feasibility study

Objective: The gold-standard treatment modality for hemifacial spasm is micro-vascular decompression (MVD) via microsurgery. Recently, endoscopic surgery has been attempted by many surgeons. The present study investigated the feasibility of robotic surgery for MVD to treat hemifacial spasm. Methods: The study was conducted using the da Vinci Xi model, and a three-dimensional model was purchased and applied. The advantages and disadvantages of microsurgery, endoscopic surgery, and robotic surgery were compared. Results: In robotic surgery, the root exit zone can be viewed from various angles by magnifying it, similarly to the endoscope and better than the microscope. However, there is a limit to performing versatile manipulations because various tools are not available. When robotic surgery is used, the camera can be applied more stably and compensate for any tremor in the surgeon’s hand, likely making surgery safer. Conclusion: Currently, the approaches for MVD using robotic surgery are limited in their application. However, when optimal tools are developed, it is expected that they can be applied as an effective treatment modality for MVD to treat hemifacial spasm.