The natural evolution of endoscopic approaches in skull base surgery: robotic-assisted surgery?

The current surgical trend is to expand the variety of minimally invasive approaches and, in particular, the possible applications of robotic systems in head and neck surgery. This is particularly intriguing in skull base regions. In this paper, we review the current literature and propose personal considerations on the role of robotic techniques in this field. A brief description of our personal preclinical experience on skull base robotic dissection represents the basis for further considerations. We are convinced that the advantages of robotic surgery applied to the posterior cranial fossa are similar to those already clinically experienced in other areas (oropharynx, tongue base), in terms of tremor-free, bimanual, precise dissection: the implementation of instruments for bony work and resolving current drawbacks will definitely increase the applicability of such a system in forthcoming years.