Endocrine Abstracts

JOINT550

Introduction: The use of robots in medical procedures is quickly replacing interventions performed by humans. Robotic surgery has significantly advanced the field of endocrine surgery, offering a range of benefits over traditional techniques. This review presents an update on the use of robotic surgery and artificial intelligence for pituitary tumors.

Methods: A systematic search of literature was conducted using the search terms robotic surgery, artificial intelligence, pituitary tumors, safety, outcome, and cost.

Results: Pituitary tumors are common neoplasms. They represent approximately 15-20% of all intracranial tumors and are benign in the majority of cases (e.g., pituitary adenomas). Pituitary carcinomas are rare neoplasms representing 0.1-0.2% of all pituitary tumors. Most pituitary adenomas are functioning tumors, mainly producing prolactin and/or growth hormone. Pituitary microadenomas (size up to 1 cm), especially prolactinomas, can benefit from pharmaceutical treatment. Transsphenoidal surgery plays an important role in the management of pituitary tumors, especially for the treatment of pituitary macroadenomas. In the context of pituitary gland operations, robotic assistance is particularly beneficial for transsphenoidal procedures where access through tight spaces with delicate surrounding tissues is required. Autonomous surgical robots can be categorized into various levels of autonomy, including partially autonomous systems performing specific tasks under human supervision, collaborative autonomy where robots work alongside human surgeons, and fully autonomous systems capable of completing entire procedures independently. The robotic system’s fine motor control and enhanced visualization increase dexterity and facilitate precise tumor removal, crucial for avoiding damage to nearby neurovascular structures. However, significant limitations restrict the applicability of robotic neurosurgery. The next generation of robotic assistance should prioritize size decrease, operating angles flexibility, and drilling with bony removal ability. While fully autonomous robotic surgery remains a long-term goal, the ongoing integration of artificial intelligence (AI) and robotics is rapidly advancing. This integration is set to revolutionize the future of robotic surgery and promise to further enhance the precision, safety, and effectiveness of surgery involving the pituitary gland. However, the current high cost of these new procedures remains a potential limitation.

Conclusion: Robotic surgery has been growing in popularity and feasibility. It offers improved dexterity and precision for the removal of pituitary tumors compared to traditional transsphenoidal surgery. Future collaboration between human surgeons and advanced robotic systems holds significant potential for improving patient care and surgical outcomes. The ongoing integration of AI and robotics can further enhance the precision, safety, and effectiveness of the surgery of pituitary tumors.