Use of the NeuroMate Stereotactic Robot in a Frameless Mode for Movement Disorder Surgery

Abstract

Background/Aims: To evaluate the use of the NeuroMate stereotactic robot with a novel ultrasound registration system for movement disorder surgery (MDS). Methods: Using the robot in a frameless mode, 51 patients underwent MDS. Surgical planning was carried out using MRI data obtained more than 24 h before surgery. Results: 37 out of 50 targets in the subthalamic nucleus were satisfactorily identified with a single microelectrode trajectory and the final electrode positions were at a mean distance of 1.7 mm from the calculated target. There was a significant improvement in motor scores of the Unified Parkinson’s Disease Rating Scale III (off medication) at 6 (43%) and 18 months (51.7%) compared to pre-operative scores (p < 0.05). Conclusions: The frameless robot using only MRI data can be used for MDS. The temporal separation of imaging from the surgical procedure provides additional time for detailed image analysis and planning.

Use of the NeuroMate stereotactic robot in a frameless mode for functional neurosurgery

“…However, it can also be used with a unique frameless ultrasound registration system. We have previously described the use of the robot in a frameless mode for movement disorder surgery (4) and in this paper we describe the preclinical evaluation of the application accuracy of the system, followed by a review of our experience of its use in functional neurosurgery.…”

Why Robots Entered Neurosurgery

“…The Evolution I robot was developed for endoscopic applications, and used in 2002 for the transphenoidal removal of pituitary adenoma [ 29 ]. The CT-based NeuroMate system became the fi rst neurosurgical robot to receive FDA approval for clinical use [ 30 ]. The Pathfi nder system followed in 2006, with highly accurate CT-guided stereotactic application [ 31 ].…”

Miniaturized rigid probe driver with haptic loop control for neurosurgical interventions

“…The tool actuator, mounted on a NeuroMate robotic system [9], is equipped with a DC mini-motor which drives a miniature ball screw through a synchronous belt with a load cell that measures contact forces within the brain tissue. The NeuroArm system, which is magnetic resonance compatible, features ultrasonic piezoelectric motors [10] and titanium multi-axis force/torque sensors on the end effector to provide three Degrees of Freedom (DoFs) force feedback, thus providing high-fidelity haptic feedback to the hand controllers.…”