An Overview of Robotics in Functional Neurosurgery

Abstract

Stereotactic techniques are used in a wide range of neurosurgical procedures. The procedures demand a high degree of spatial accuracy and minimal error. There are diverse functional surgeries that require stereotactic procedures, including deep brain stimulation, brain biopsies, and epilepsy procedures. Though the disease processes are diverse, all these procedures require accurate targeting of deep structures without visual guidance. The use of robots for stereotactic procedures is a natural progression in the surgeon's quest for higher accuracy and lower complications. This paper reviews the role of robots in stereotactic procedures and outlines current status of robots in stereotactic procedures. The shortcomings of current systems and an outline of an ideal stereotactic device are presented.

Design and Development of Multi-axis Manipulator for Data Acquisition for Neurosurgery Applications.

“…One commonly used approach involves the use of an optical tracking device. This technique involves several steps, including preoperative imaging using a CT or MRI scan, registration of image data into the neuro-navigation system, tracking of the patient's head and surgical tools using an optical tracking device attached to the patient's cranium, and visualization of real-time images of the surgical area overlaid with the patient's brain anatomy [10,11,13]. Optical tracking devices use either active or inactive infrared markers to monitor the location of the object in real-time, with the position of the point of reflection determined using a camera system [2,3].…”

“…The AR view is created by combining live video from a tracked microscope with 3D renderings of preoperative images aligned with the tracking system's reference. [5,10] The view can be displayed within the microscope's lenses or on the navigation system. The target area is identified and marked on the patient's head using the frame with reference to the navigation system.…”

Neurosurgical robots and ethical challenges to medicine

“…These include image acquisition distortions and errors in the areas of framing, kinematics, and camera and robot calibration. Also, there are persistent problems in visual confirmation accuracy and brain tissue displacement (Widmann et al 2012, Vazhayil et al 2019. Furthermore, neurosurgical robot designs are problematic since they may obstruct a view of a surgical site, or are unable to imitate the tactile dexterity of a neurosurgeon (Kelly 2002).…”