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E-017 Robotic neurovascular surgery: Single center experience and review of the literature

Introduction Robotic surgery is rapidly expanding its utility in endovascular neurosurgery. In contrast to most medical disciplines, endovascular neurosurgery is an extremely time dependent discipline and door-to-needle time is absolutely critical in scenarios such as acute ischemic stroke (AIS). Yet, a large percentage of the US population is far away from receiving timely interventions. This is where robotics could play a role in expanding prompt diagnosis and acute treatment for these rapidly progressive pathologies. Methods We will retrospectively analyze a series of 30 patients that underwent robotically-assisted neurovascular diagnosis and intervention procedures between December 2020 and March 2021 at our institution with the CorPath GRX robot. Additionally, a matched control group of manually operated endovascular procedures will be obtained. Finally, a review of the literature will be offered. Indications for the procedure, procedural time, patient radiation exposure, physician radiation exposure, anesthesia time, contrast media volume, conversion to manual control, treatment success and complications will be analyzed and compared in both groups. Results We will report the number of robotically-assisted procedures that were performed in the total number of patients. Descriptive statistics (mean and standard deviation, where appropriate) will be reported for sex distribution, age, indication(s), procedural time, patient radiation exposure for the health personnel and the patient, anesthesia time, amount of contrast media needed, procedure success (including the number of conversions to manual procedure and rationale), complications, and follow-up will be reported. A thorough comparison between the two groups will be done using chisquare and t-tests. Conclusions Robotic surgery has enormous potential in endovascular neurosurgery. Robotically-assisted surgeries may help reduce time to reperfusion in AIS, as well as limit radiation exposure for health personnel and patients. Furthermore, its use could expand acute cerebrovascular treatments to underserved areas and telementoring. The implementation of robotic surgery has the potential to fundamentally change global urgent neurovascular diseases prognosis and has the power to reduce monetary burden for hospitals and rehabilitation centers derived from the delayed care of the mentioned conditions. Thus far, the technology has demonstrated to be safe and feasible for very precise indications, as demonstrated by animal models and small human series (making for a total of 89 patients described so far in the literature). Despite all these alleged potential benefits, investigations among larger cohorts are needed to demonstrate consistent performance, patient benefit and safety, and to encourage a more widespread use. Note We cannot submit the data yet, since we are waiting for IRB approval for this project. We estimate that we will be ready to send the full version within the next 15 days. We would really appreciate it if you consider this special circumstance since this work will represent the largest cohort of robotic-assisted endovascular cases presented in the literature. Disclosures M. Costa: None. C. Pierre: None. M. Basamh: None. A. Patel: None. S. Monteith: None.