Technical Note

Minimally Invasive Spine Surgery (TLIF) using the RoboticScope


The technical note we share with you in this post, was released by the Department of Clinical Neurosciences, Spine Surgery Center of Lausanne University Hospital, Switzerland.


The authors (Rossi-Mossuti, F. et al., 2021) show that working with the RoboticScope fitted well into the workflow of a Minimally Invasive Transforaminal Interbody Fusion (TLIF) and identify other advantages of working with the RoboticScope in minimally invasive spine surgery.



RoboticScope helping overcome possible disadvantages

Challenges with traditional microscopes in minimally invasive spine procedures can be the need of repetitive movements of the microscope, limited field of view (focus) and focal length, which can lead to difficulty maintaining proper visualization when working with long instruments. 



Seamless and safe integration into the usual operative process

The authors state that the RoboticScope not only integrated seamlessly and safely into the usual operative process, but also fitted well with their established workflow of a MIS-TLIF. It was observed that the surgeon was able to stay in an ergonomic, comfortable position, even in case of extreme tubular retractor angulations which led to a significant reduction in tension and muscle fatigue.


The available workspace under magnification was evaluated superior to the institution’s standard microscope as throughout the whole procedure the instruments, especially when using long instruments, could be kept in the surgical field. This could help prevent unintentional hand deviations and complications during microsurgical procedures.


The overall outcome was good, no intra- or perioperative complications occurred, and all four pedicle screws placed, were assessed as grade A according to the Gertzbein-Robbins scale. (Gertzbein et al., 1990)



Measuring the training progress

“The first transition from one point to another in the mock surgical field took 10 seconds, but after 1 hour of training went down to 3 seconds. Focusing took 8 seconds vs 2 seconds after 1 hour of training. Control of the camera was highly intuitive, and no difficulties controlling the position and movements of the camera were encountered. During the real surgery, focusing and moving from one point to another required the same amount of time as after the 1-hour training period.” (Rossi-Mossuti, F. et al., 2021)  



Original article: Frederic Rossi-Mossuti, Timo Ecker, Marco Germann, Juan Barges-Coll. Robotic-Assisted Minimally Invasive Transforaminal Interbody Fusion (TLIF) Using A New Hands-Free 3D Digital Microscope with HeadMounted Display (HMD): Technical Note. IJ Clin Img and med Rew. 2021; 1(1): 1004.