Robotics in neurosurgery

McBeth, Paul B.; Louw, Deon; Rizun, Peter; Sutherland, Garnette R.

doi:10.1016/j.amjsurg.2004.08.004

Cited by 95 publications

(60 citation statements)

References 27 publications

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“…Over the next 3 decades, the use of medical robots has rapidly expanded to several specific fields, such as soft-tissue, urological, orthopedic, general laparoscopic, and cardiac surgeries. 38,45,56 Robotic assistance was developed in neurosurgical procedures with the aim of improving feasibility and effectiveness of several procedures that require a high level of accuracy and safety, such as biopsy, 36 OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety.…”

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confidence: 99%

Robot-assisted procedures in pediatric neurosurgery

Benedictis¹,

Trezza

Carai³

et al. 2017

Neurosurgical Focus

135

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OBJECTIVEDuring the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures. Nevertheless, the use of robots has been rarely reported in children. In this work, the authors describe their experience using the ROSA device (Robotized Stereotactic Assistant) in the neurosurgical management of a pediatric population.METHODSBetween 2011 and 2016, 116 children underwent ROSA-assisted procedures for a variety of diseases (epilepsy, brain tumors, intra- or extraventricular and tumor cysts, obstructive hydrocephalus, and movement and behavioral disorders). Each patient received accurate preoperative planning of optimal trajectories, intraoperative frameless registration, surgical treatment using specific instruments held by the robotic arm, and postoperative CT or MR imaging.RESULTSThe authors performed 128 consecutive surgeries, including implantation of 386 electrodes for stereo-electroencephalography (36 procedures), neuroendoscopy (42 procedures), stereotactic biopsy (26 procedures), pallidotomy (12 procedures), shunt placement (6 procedures), deep brain stimulation procedures (3 procedures), and stereotactic cyst aspiration (3 procedures). For each procedure, the authors analyzed and discussed accuracy, timing, and complications.CONCLUSIONSTo the best their knowledge, the authors present the largest reported series of pediatric neurosurgical cases assisted by robotic support. The ROSA system provided improved safety and feasibility of minimally invasive approaches, thus optimizing the surgical result, while minimizing postoperative morbidity.

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mentioning

confidence: 99%

Robot-assisted procedures in pediatric neurosurgery

Benedictis¹,

Trezza

Carai³

et al. 2017

Neurosurgical Focus

135

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“…10 Accuracy is a key point for stereotactic neurosurgical procedures, particularly for implantations of deep brain stimulation (DBS) electrodes. The Neuromate robot (Renishaw) is a commercially available neurosurgical robot used in many centers around the world for stereotactic and endoscopic procedures (Fig.…”

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confidence: 99%

In vivo measurement of the frame-based application accuracy of the Neuromate neurosurgical robot

Langsdorff

Paquis

Fontaine

2015

JNS

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obJect The application accuracy of the Neuromate neurosurgical robot has been validated in vitro but has not been evaluated in vivo for deep brain stimulation (DBS) electrode implantations. The authors conducted a study to evaluate this application accuracy in routine frame-based DBS procedures, with an independent system of measurement. MethoDs The Euclidian distance was measured between the point theoretically targeted by the robot and the point actually reached, based on their respective stereotactic coordinates. The coordinates of the theoretical target were given by the robot's dedicated targeting software. The coordinates of the point actually reached were recalculated using the Stereoplan localizer system. This experiment was performed in vitro, with the frame fixed in the robot space without a patient, for 21 points spatially distributed. The in vivo accuracy was then measured in 30 basal ganglia targets in 17 consecutive patients undergoing DBS for movement disorders. Results The mean in vitro application accuracy was 0.44 ± 0.23 mm. The maximal localization error was 1.0 mm. The mean (± SD) in vivo application accuracy was 0.86 ± 0.32 mm (∆x = 0.37 ± 0.34 mm, ∆y = 0.32 ± 0.24 mm, ∆z = 0.58 ± 0.31 mm). The maximal error was 1.55 mm. conclusions The in vivo application accuracy of the Neuromate neurosurgical robot, measured with a system independent from the robot, in frame-based DBS procedures was better than 1 mm. This accuracy is at least similar to the accuracy of stereotactic frame arms and is compatible with the accuracy required in DBS procedures.http://thejns.org/doi/abs/10.3171/2014.9.JNS14256 Key WoRDs accuracy; deep brain stimulation; Neuromate robot; stereotactic frame; functional neurosurgery abbReviations DBS = deep brain stimulation; SEEG = stereoelectroencephalography.

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“…La mayoría de estos sistemas se han empleado en cirugía endoscópica u otros procedimientos de cirugía mínimamente invasiva. [2][3][4][5][6][7][8] El robot AESOP ® fue el primer sistema robótico aprobado para cirugía por la FDA en 1994. Este robot actuaba llevando la cáma-ra en cirugía laparoscópica.…”

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Tecnología robótica en cirugía oral y maxilofacial

Madrid¹

2008

Rev Esp Cirug Oral y Maxilofac

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Resumen: La utilización de robots en cirugía como ayudantes o como cirujanos despierta interés desde hace décadas. Sus características de precisión, incansabilidad y muchas otras ventajas auguran a esta tecnología un papel destacado en la cirugía maxilofacial del futuro. No obstante, las experiencias en nuestro campo y en otras especialidades quirúrgicas han puesto de manifiesto la falta de madurez de la tecnología robótica para incorporarse a corto plazo a los quirófanos. La introducción de tecnologí-as para una mayor miniaturización, su actuación cooperativa y una mejor interacción con el medio pueden aportar las características que necesitan para ser útiles y definitivamente incorporarse a nuestra actividad. Tecnología robótica en cirugía oral y maxilofacial 10 Rev Esp Cir Oral y Maxilofac 2008;30,1 (enero-febrero):9-15 © 2008 ergon IntroducciónSe atribuye a Aristóteles en el siglo IV ac. el concepto de la automatización. En aquellos tiempos escribió sus pensamientos sobre como mejorar los autó-matas de la época: "...si cada instrumento pudiera hacer su propio trabajo, obedeciendo y anticipando las órdenes ... si la lanzadera supiera tejer, si la púa supiera tocar la lira sin la mano que las guiara, los amos no necesitarían tener siervos". 1 Lo que Aristóteles proponía iba más allá de los simples autómatas, que repiten mecá-nicamente los movimientos para los que han sido programados. Introdujo la necesidad de una cierta inteligencia detrás de los movimientos de los dispositivos, dotándolos de una capacidad para tomar decisiones sobre la marcha. Para que un dispositivo pueda tomar decisiones sobre sus movimientos, deduciendo la acción más conveniente, es necesario un cierto juicio o inteligencia y un cierto grado de percepción del entorno.Los autómatas ya aparecieron en la antigua Grecia, aunque con poca aplicabilidad práctica y se usaban más como divertimento que como herramientas útiles. El único autómata que realmente tuvo aplicación práctica fue el reloj.El robot concebido como autómata tiene muchas limitaciones en cirugía, debido al cambiante entorno de trabajo y combinación de estructuras elásticas, flexibles, fluidas, viscosas y sólidas que componen los seres vivos. Estos problemas son los que hacen difícil trasladar al quirófano a los eficientes robots industriales, que de forma económica e incansable, con rapidez y precisión, son capaces de pintar un coche o montar un televisor. Los requerimientos para los ingenieros son altísimos, pues en la práctica se les pide que reproduzcan y mejoren de forma robótica las prestaciones de un ser humano.Los primeros robots empleados en cirugía actuaban como autó-matas, ejecutando rigurosamente su programación o los movimientos de un operador del sistema, sin interacción con el medio y sin tomar decisiones por sí mismos.Las experiencias clínicas se iniciaron a finales de los 80 en cirugía gastrointestinal, urología y cirugía cardiaca. La mayoría de estos sistemas se han empleado en cirugía endoscópica u otros procedimientos de cirugía mínimamente invasiva. [2][3][4]...

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Robotics in neurosurgery

Cited by 95 publications

References 27 publications

Robot-assisted procedures in pediatric neurosurgery

Robot-assisted procedures in pediatric neurosurgery

In vivo measurement of the frame-based application accuracy of the Neuromate neurosurgical robot

Tecnología robótica en cirugía oral y maxilofacial

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