Navigation, mixed reality, and robotics in endoscopic spine surgery

Abstract

Endoscopic spine surgery (ESS) is an ultra-minimally invasive technique through which spinal pathology can be addressed via sub-centimeter incisions with negligible soft tissue disruption. However, concerns exist regarding the steep learning curve, operative time, and radiation exposure to the surgical team. The use of intraoperative navigation, mixed reality, and robotics in the setting of ESS is currently being explored, and the early evidence suggests that such technologies may help mitigate these issues. The application of these technologies in ESS as well as the associated literature is reviewed herein.

Development of an Endoscopic Spine Surgery Program

“…Other future advancements in ESS include developing artificial intelligence and robotics to aid in accurate and consistent cannula placement with use of image recognition 56 . This technology has the potential to reduce the steep learning curve associated with ESS and to improve the quality and consistency of ESS procedures 57 .…”

“…In addition, enhancements in 3D navigation technology along with the implementation of ESS training models are predicted to aid surgeons in overcoming the learning curve associated with achieving ESS proficiency 34 . Moreover, augmented reality has the potential to drive ESS advancement further through the use of head-mounted optical see-through displays, which allow surgeons to remain focused on the surgical site rather than look up at the monitor 56 . In the future, artificial intelligence may be used to perform real-time structure recognition to guide surgeons during procedures 58 .…”