Work

Navigated robotic-arm-assisted hybrid multi-portal endoscopic fenestration of a thoracic intradural arachnoid cyst: a technical case report

Year: 2026

Type: article

Abstract: Endoscopic treatment of spinal intradural lesions is technically demanding because bimanual manipulation, irrigation control, neural protection, and dural closure are constrained. A 44-year-old woman with myelopathy from a dorsal T4-T10 intradural arachnoid cyst underwent endoscopic fenestration at T4/5. The hybrid multi-portal technique combined unilateral biportal-style exposure, a uniportal working-channel endoscope, intraoperative navigation, and robotic-arm camera stabilization. An accessory portal enabled bimanual intradural manipulation. Irrigation pressure was reduced after durotomy, and the dura was closed with sutures and clips reinforced by sealants. Day 1 magnetic resonance imaging confirmed cord decompression, and lower-limb sensory and bladder symptoms had resolved at 6 weeks. To our knowledge, this is the first reported navigated robotic-arm-assisted hybrid multi-portal endoscopic fenestration of a thoracic intradural arachnoid cyst. This single case demonstrates technical feasibility but not superiority over open or microscopic surgery.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjag998

Authors: Cecilia Wanchen Huo, Ralph J Mobbs, Yi Yuen Wang

Institutions: The Alfred Hospital, Alfred Health, UNSW Sydney, Prince of Wales Hospital

Language: English

Topic: Neurosurgical Procedures and Complications

Subfield: Clinical Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000