Navigated robotic-arm-assisted hybrid multi-portal endoscopic fenestration of a thoracic intradural arachnoid cyst: a technical case report
Abstract
Endoscopic treatment of spinal intradural lesions is technically demanding because bimanual manipulation, irrigation control, neural protection, and dural closure are constrained. A 44-year-old woman with myelopathy from a dorsal T4–T10 intradural arachnoid cyst underwent endoscopic fenestration at T4/5. The hybrid multi-portal technique combined unilateral biportal-style exposure, a uniportal working-channel endoscope, intraoperative navigation, and robotic-arm camera stabilization. An accessory portal enabled bimanual intradural manipulation. Irrigation pressure was reduced after durotomy, and the dura was closed with sutures and clips reinforced by sealants. Day 1 magnetic resonance imaging confirmed cord decompression, and lower-limb sensory and bladder symptoms had resolved at 6 weeks. To our knowledge, this is the first reported navigated robotic-arm-assisted hybrid multi-portal endoscopic fenestration of a thoracic intradural arachnoid cyst. This single case demonstrates technical feasibility but not superiority over open or microscopic surgery.
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BibTeX
@article{huo2026navigated,
title = {{Navigated robotic-arm-assisted hybrid multi-portal endoscopic fenestration of a thoracic intradural arachnoid cyst: a technical case report}},
author = {Cecilia Wanchen Huo and Ralph J Mobbs and Yi Yuen Wang},
journal = {Journal of Surgical Case Reports},
year = {2026},
month = nov,
doi = {10.1093/jscr/rjag998},
url = {https://doi.org/10.1093/jscr/rjag998},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Navigated robotic-arm-assisted hybrid multi-portal endoscopic fenestration of a thoracic intradural arachnoid cyst: a technical case report
AU - Cecilia Wanchen Huo
AU - Ralph J Mobbs
AU - Yi Yuen Wang
PY - 2026
DA - 2026/11/04
JO - Journal of Surgical Case Reports
DO - 10.1093/jscr/rjag998
UR - https://doi.org/10.1093/jscr/rjag998
AB - Endoscopic treatment of spinal intradural lesions is technically demanding because bimanual manipulation, irrigation control, neural protection, and dural closure are constrained. A 44-year-old woman with myelopathy from a dorsal T4–T10 intradural arachnoid cyst underwent endoscopic fenestration at T4/5. The hybrid multi-portal technique combined unilateral biportal-style exposure, a uniportal working-channel endoscope, intraoperative navigation, and robotic-arm camera stabilization. An accessory portal enabled bimanual intradural manipulation. Irrigation pressure was reduced after durotomy, and the dura was closed with sutures and clips reinforced by sealants. Day 1 magnetic resonance imaging confirmed cord decompression, and lower-limb sensory and bladder symptoms had resolved at 6 weeks. To our knowledge, this is the first reported navigated robotic-arm-assisted hybrid multi-portal endoscopic fenestration of a thoracic intradural arachnoid cyst. This single case demonstrates technical feasibility but not superiority over open or microscopic surgery.
SN - 2042-8812
ER -