Teleoperation of Concentric Tube Robots for Skull Base Applications: Pituitary Surgery at a Distance?

Introduction: Teleoperation for surgical procedures and related activities is a long sought goal. This has become progressively within reach with advances in robotics as well as the speed of data transfer between operator and robot. Teleoperation would allow for the widespread dissemination of “expert” operations where personnel and equipment resources may be suboptimal, greatly expand access to advanced medical technology and knowledge worldwide, and present a myriad of training and other educational opportunities. Our laboratory has developed concentric tube robots for skull base surgery that has been described previously. These consist of concentric prebent nitinol tubes with various end effectors that can be precisely controlled by the operator using a hand held haptic device. In this work, the robot was used to resect a phantom pituitary tumor at a remote location (surgeon in Nashville, Tennessee, United States, robot in Chapel Hill, North Carolina, United States) using an Internet-based data link.