And this is not an accident! Since 2008, in the Pirogov Center, a robotic surgical complex (RSC) “Da Vinci” was used in surgical practice. The experience of more than 1200 surgical interventions in various fields has been accumulated. Development of new directions for the use of the RSC is one of the priorities of our specialists.

Until now, the use of the Da Vinci RSC in neurosurgery has not been properly disseminated. This is due both to the technically complex combination of Da Vinci technology with other neurosurgical equipment — the navigation system, the X-ray electron-optical converter, the ultrasonic bone knife, the high-speed boron, etc., and the exclusivity of thoracoscopic operations on the spine.

On April 24, 2018, a combined team of surgeons (thoracic and neurosurgeons) performed an operation to remove the ossified hernia of the intervertebral disc with compression of the spinal cord at the thoracic level of the spine.

The first stage through the pleural cavity was performed by robot-assisted access to the anterior sections of the spine, with a precise separation of the head of the rib, the body of the vertebra and the intervertebral disc, resection of the head of the rib. The second stage the ossified disc hernia was removed thoracoscopically with the use of an ultrasound knife. The postoperative period is smooth, the patient is discharged after 5 days to continue treatment with a neurologist at the place of residence.

It should be noted that in connection with the development of this disease, the patient developed a deep paresis in the legs according to the central type with a disruption of the functions of the pelvic organs. After the surgery, there was a real chance of restoring the patient and returning him to an active lifestyle.

The first impressions of using the “Da Vinci” technology are very positive. It is important to emphasize that for the full implementation of this technology in the routine practice, it is necessary to work together technologists and surgeons: in order to optimize the instrumentation, develop special robotic manipulators and integrate some neurosurgical equipment with the “Da Vinci” system.

Fig. 1. Setting up the Da Vinci patient rack
Fig. 2. Robot-assisted stage of operation
Fig. 3. Robotic hand

Fig. 4. MRI before surgery. Axial section
Fig. 5. MRI sagittal section
Fig. 6. CT scan after surgery. Axial section

Fig. 7. CT scan after surgery. Sagittal section