• John Y K Lee, Deb A Bhowmick, Daniel D Eun, and William C Welch.
• Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
• J Neurol Surg A Cent Eur Neurosurg. 2013 Jul 1;74(4):258-61.

BackgroundMinimally invasive techniques in spine surgery have gained significant popularity due to decreased tissue dissection and destruction, postoperative pain, and hospital stay. The laparoscopic anterior lumbar interbody fusion (ALIF), an innovation in minimally invasive spine surgery, is rarely done because it has marginal benefit over the mini-open ALIF technique in rates of retrograde ejaculation and vascular complications. We propose these outcomes can be improved with enhanced robotic-assisted dissection and exposure for ALIF.PatientsTwo patients with single-level degenerative spine disease at L5-S1, associated with mechanical back pain, underwent anterior spinal exposure using the da Vinci S Surgical Robot during ALIF.ResultsIn this report, we provide the first description of the use of a surgical robot in the dissection and exposure for ALIF in patients with degenerative spine disease. We demonstrate successful use of the da Vinci Surgical Robot in separating the presacral nervous plexus from retroperitoneal structures without postoperative vascular or urological complications over a 1-year follow-up period.ConclusionUse of the robotic assistance in the performance of ALIF is possible without significant operative complications. This technique may provide added benefit over conventional laparoscopic approaches to the spine.Georg Thieme Verlag KG Stuttgart · New York.

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