A novel miniature robotic guidance device for stereotactic neurosurgical interventions: preliminary experience with the iSYS1 robot

Abstract

OBJECTIVE Robotic devices have recently been introduced in stereotactic neurosurgery in order to overcome the limitations of frame-based and frameless techniques in terms of accuracy and safety. The aim of this study is to evaluate the feasibility and accuracy of the novel, miniature, iSYS1 robotic guidance device in stereotactic neurosurgery. METHODS A preclinical phantom trial was conducted to compare the accuracy and duration of needle positioning between the robotic and manual technique in 162 cadaver biopsies. Second, 25 consecutive cases of tumor biopsies and intracranial catheter placements were performed with robotic guidance to evaluate the feasibility, accuracy, and duration of system setup and application in a clinical setting. RESULTS The preclinical phantom trial revealed a mean target error of 0.6 mm (range 0.1-0.9 mm) for robotic guidance versus 1.2 mm (range 0.1-2.6 mm) for manual positioning of the biopsy needle (p < 0.001). The mean duration was 2.6 minutes (range 1.3-5.5 minutes) with robotic guidance versus 3.7 minutes (range 2.0-10.5 minutes) with manual positioning (p < 0.001). Clinical application of the iSYS1 robotic guidance device was feasible in all but 1 case. The median real target error was 1.3 mm (range 0.2-2.6 mm) at entry and 0.9 mm (range 0.0-3.1 mm) at the target point. The median setup and instrument positioning times were 11.8 minutes (range 4.2-26.7 minutes) and 4.9 minutes (range 3.1-14.0 minutes), respectively. CONCLUSIONS According to the preclinical data, application of the iSYS1 robot can significantly improve accuracy and reduce instrument positioning time. During clinical application, the robot proved its high accuracy, short setup time, and short instrument positioning time, as well as demonstrating a short learning curve.

Brain biopsy performed with the RONNA G3 system: a case study on using a novel robotic navigation device for stereotactic neurosurgery

“…A limited number of studies dealing with robotized stereotactic brain biopsies were identified in the literature. Bearing in mind this rather small number of different robots used for stereotactic brain biopsy and also a limited number of documented procedures, we believe that our robotic system, which successfully performed a stereotactic brain biopsy using a novel robotic localization device, will be of interest to researchers and clinicians in the field.…”

“…Stereotactic brain biopsy is a typical stereotactic procedure used to determine the histological diagnosis of unknown brain lesions . In recent years, a number of robotic systems have been used for stereotactic brain biopsy procedures . In this paper, we report the first case of a frameless brain biopsy performed with the RONNA G3 robotic neuronavigation system (Figure ).…”

A new tool for touch-free patient registration for robot-assisted intracranial surgery: application accuracy from a phantom study and a retrospective surgical series

“…Minchev et al 18 reported a mean accuracy of 0.6 mm (range 0.1-0.9 mm) with a 3D CT data set (slice thickness 0.625 mm), optical tracking registration (Medtronic StealthStation S7), and iSYS1 robot (Medizintechnik) in a 162-trajectory study. LEs were measured by means of a digital caliper.…”

Highlights from the First Annual Spinal Navigation, Emerging Technologies and Systems Integration Meeting

“…Robotic systems evenly allow for higher accuracy and reduced radiation exposure when compared to free hand pedicle screw placement. Compared to navigation systems, a benefit of robotic systems is their potential of being more time efficient, as the ideal trajectory is set by the robot and not manually (14). To our knowledge as of now, no study compared the use of navigation systems to robotic systems in terms of screw accuracy and patient safety.…”