1.Robotic-Assisted Uniportal Full-Endoscopic Transforaminal Lumbar Interbody Fusion: A Technical Note on a Hybrid Form of Minimally Invasive Surgery
Ting Yao ANG ; A. Aravin KUMAR ; Chin Hong NGAI ; John J.Y. ZHANG ; Jacob Y.L. OH ; Ji Min LING ; Thomas C.H. TAN
Journal of Minimally Invasive Spine Surgery and Technique 2026;11(1):105-117
Robotic-assisted pedicle screw placement and full-endoscopic transforaminal lumbar interbody fusion (FE-TLIF) are established minimally invasive spine techniques. Their integration has the potential to combine navigation accuracy with the muscle-preserving advantages of uniportal endoscopy. This technical note describes a hybrid approach using the Mazor X Stealth edition robotic system to enhance workflow, safety, and efficiency during FE-TLIF. A 74-year-old patient with metabolic syndrome presented with severe back and radicular leg pain that was refractory to conservative treatment. Magnetic resonance imaging demonstrated bilateral lateral recess stenosis, disc height loss, and facet arthropathy at L4–5, with dynamic instability observed on flexion-extension radiographs. Preoperative computed tomography imaging was uploaded to the robotic system for trajectory planning. Following registration, the robotic arm guided percutaneous pedicle screw placement via Wiltse incisions. Uniportal endoscopic access enabled hemilaminotomy, facetectomy, discectomy, endplate preparation, and insertion of an expandable L4–5 interbody cage under direct visualization. Robotic guidance facilitated precise screw trajectory placement without repeated fluoroscopic localization, reduced intraoperative radiation exposure, and avoided muscle disruption associated with open approaches. Endoscopic visualization enabled controlled facet resection and preservation of neural elements during cage placement. Postoperative radiographs confirmed appropriate implant positioning. The combined workflow improved surgical ergonomics and minimized tissue trauma while maintaining fusion stability. Robotic-assisted FE-TLIF represents a safe and feasible hybrid minimally invasive surgery technique that enhances pedicle screw accuracy and complements endoscopic fusion. Despite a steep learning curve, this approach may reduce perioperative morbidity, improve procedural efficiency, and enhance postoperative recovery. Further comparative studies are required to evaluate long-term clinical and radiographic outcomes.
2.Haemaphysalis wellingtoni (Acari: Ixodidae) from the spotted wood owl (Strix seloputo) (Aves: Strigiiformes): a new tick-host record in Peninsular Malaysia
Tan Tan, L.P. ; Roslan N.S. ; Kazim A.R. ; Che Wan Zalati ; C.W.S. ; Hassan H. ; Heo C.H.
Tropical Biomedicine 2026;43(No. 1):16-21
Multiple engorged tick nymphs (n= 6) were collected from an injured spotted wood owl (Strix seloputo)
in Kelantan, Peninsular Malaysia. Morphological identification of the nymphs revealed that the ticks
were Haemaphysalis wellingtoni, based on several distinctive features: (1) internal edge of palpal
article III extending far beyond the internal edge of palpal article II; and (2) four feathery and closespaced infrainternal setae. Subsequent molecular analysis of a randomly selected nymph targeting the
mitochondrial 16S gene corroborated with the species identity of the tick. To date, this is first report of
the infestation of H. wellingtoni on S. seloputo. Future studies are needed to determine whether native
or endemic birds may serve as disseminators of ticks and tick-borne diseases.
3.Low efficacy of delthamethrin-treated net against Singapore Aedes aegypti is associated with kdr-type resistance
Pang, S.C ; Chiang, L.P ; Tan, C.H ; Vythilingam, I ; Lam-Phua, S.G ; Ng, L.C.
Tropical Biomedicine 2015;32(1):140-150
There has been a worldwide surge in the number and severity of dengue in the past
decades. In Singapore, relentless vector control efforts have been put in to control the
disease since the 1960’s. Space spraying, fogging, chemical treatment and source reduction
are some commonly used methodologies for controlling its vectors, particularly Aedes aegypti.
Here, as we explored the use of a commercially available delthamethrin-treated net as an
alternative strategy and the efficacy of the treated net was found to be limited. Through
bioassays and molecular studies, the failure of the treated net to render high mortality rate
was found to be associated with the knockdown resistance (kdr) mutation. This is the first
report of kdr- mutations in Singapore’s Ae. aegypti. At least one point mutation, either
homozygous or heterozygous, at amino acid residue V1016G of DIIS6 or F1269C of DIIIS6
was detected in 93% of field strains of Ae. aegypti. Various permutations of wild type and
mutant amino acids of the four alleles were found to result in varying degree of survival rate
among local field Ae. aegypti when exposed to the deltamethrin treated net. Together with
the association of higher survival rate with the presence of both V1016G and F1269C, the
data suggest the role of these mutations in the resistance to the deltamethrin. The high
prevalence of these mutations were confirmed in a country wide survey where 70% and 72%
of the 201 Ae. aegypti analysed possessed the mutations at residues 1016 and 1269 respectively.
The highest mutated frequency combination was found to be heterozygous alleles (VG/FC) at
both residues 1016 and 1269 (37.8%), followed by homozygous mutation at allele 1269 (24.4%)
and homozygous mutation at allele 1016 (22.9%). The kdr- type of resistance among the
vector is likely to undermine the effectiveness of pyrethroids treated materials against these
mosquitoes.


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