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Robotized neurosurgery

Rebecca J Park, Ilina Singh, Alexandra C Pike, Jacinta O A Tan
Neurosurgical interventions for psychiatric disorders have a long and troubled history (1, 2) but have become much more refined in the last few decades due to the rapid development of neuroimaging and robotic technologies (2). These advances have enabled the design of less invasive techniques, which are more focused, such as deep brain stimulation (DBS) (3). DBS involves electrode insertion into specific neural targets implicated in pathological behavior, which are then repeatedly stimulated at adjustable frequencies...
2017: Frontiers in Psychiatry
Oliver Zettinig, Benjamin Frisch, Salvatore Virga, Marco Esposito, Anna Rienmüller, Bernhard Meyer, Christoph Hennersperger, Yu-Mi Ryang, Nassir Navab
PURPOSE: We present a fully image-based visual servoing framework for neurosurgical navigation and needle guidance. The proposed servo-control scheme allows for compensation of target anatomy movements, maintaining high navigational accuracy over time, and automatic needle guide alignment for accurate manual insertions. METHOD: Our system comprises a motorized 3D ultrasound (US) transducer mounted on a robotic arm and equipped with a needle guide. It continuously registers US sweeps in real time with a pre-interventional plan based on CT or MR images and annotations...
February 24, 2017: International Journal of Computer Assisted Radiology and Surgery
Stefan Hunsche, Dieter Sauner, Faycal El Majdoub, Clemens Neudorfer, Jörg Poggenborg, Axel Goßmann, Mohammad Maarouf
Intraoperative assessment of lead localization has become a standard procedure during deep brain stimulation surgery in many centers, allowing immediate verification of targeting accuracy and, if necessary, adjustment of the trajectory. The most suitable imaging modality to determine lead positioning, however, remains controversially discussed. Current approaches entail the implementation of computed tomography and magnetic resonance imaging. In the present study, we adopted the technique of intensity-based 2D 3D registration that is commonly employed in stereotactic radiotherapy and spinal surgery...
March 21, 2017: Physics in Medicine and Biology
Marc D Moisi, Kimberly Hoang, R Shane Tubbs, Jeni Page, Christian Fisahn, David Paulson, Shiveindra Jeyamohan, Johnny Delashaw, David Hanscom, Rod J Oskouian, Jens Chapman
INTRODUCTION: The operating microscope (OM) has become instrumental in aiding surgeons during key microdissection with greater safety and detail. An exoscope offers similar detail with improved functionality and greater implications for live teaching and improved operating room flow. METHODS: Eleven senior neurosurgery residents and fellows performed unilateral, single-level laminotomies on fresh cadavers using an OM and exoscope. Three attending spine surgeons blinded for the visualization technique used then reviewed and graded each decompression...
February 2017: World Neurosurgery
Sungmin Kim, Peter Kazanzides
PURPOSE: Image-guided surgery requires registration between an image coordinate system and an intraoperative coordinate system that is typically referenced to a tracking device. In fiducial-based registration methods, this is achieved by localizing points (fiducials) in each coordinate system. Often, both localizations are performed manually, first by picking a fiducial point in the image and then by using a hand-held tracked pointer to physically touch the corresponding fiducial on the patient...
February 2017: International Journal of Computer Assisted Radiology and Surgery
Michael A Bohl, Mark E Oppenlander, Robert Spetzler
The unique challenges inherent to microneurosurgery demand that we stay on the forefront of new surgical technologies. Many believe the next major technological advance in neurosurgery will be the widespread application of image-guided robotics in the operating room. We evaluated a novel technology for image-guided robotic auto-navigation of the operating microscope in a prospectively enrolled cohort of patients. Twenty patients were prospectively enrolled for analysis. Data were collected on the extent of resection, operative time, estimated blood loss, time taken to set up the new software, and complications encountered...
June 30, 2016: Curēus
Yaser Maddahi, Kourosh Zareinia, Liu Shi Gan, Christina Sutherland, Sanju Lama, Garnette R Sutherland
The use of robotic technology in the surgical treatment of brain tumour promises increased precision and accuracy in the performance of surgery. Robotic manipulators may allow superior access to narrow surgical corridors compared to freehand or conventional neurosurgery. This paper reports values and ranges of tool-tissue interaction forces during the performance of glioma surgery using an MR compatible, image-guided neurosurgical robot called neuroArm. The system, capable of microsurgery and stereotaxy, was used in the surgical resection of glioma in seven cases...
2016: BioMed Research International
Anouar Jarraya, Smaoui Mohamed, Laabidi Sofiene, Kamel Kolsi
Near-infrared spectroscopy (NIRS) allows continuous noninvasive monitoring of in vivo oxygenation in selected tissues. It has been used primarily as a research tool for several years, but it is seeing wider application in the clinical arena all over the world. It was recently used to monitor brain circulation in cardiac surgery, carotid endarteriectomy, neurosurgery and robotic surgery. According to the few studies used NIRS in pregnancy, it may be helpful to assess the impact of severe forms of preeclampsia on brain circulation, to evaluate the efficacy of different treatments...
2016: Pan African Medical Journal
P Mazzone, P Arena, L Cantelli, G Spampinato, S Sposato, S Cozzolino, P Demarinis, G Muscato
The use of robotics in neurosurgery and, particularly, in stereotactic neurosurgery, is becoming more and more adopted because of the great advantages that it offers. Robotic manipulators easily allow to achieve great precision, reliability, and rapidity in the positioning of surgical instruments or devices in the brain. The aim of this work was to experimentally verify a fully automatic "no hands" surgical procedure. The integration of neuroimaging to data for planning the surgery, followed by application of new specific surgical tools, permitted the realization of a fully automated robotic implantation of leads in brain targets...
July 2016: Journal of Neural Transmission
Y Zhang, X J Liu
Digital medical technologies or computer aided medical procedures, refer to imaging, 3D reconstruction, virtual design, 3D printing, navigation guided surgery and robotic assisted surgery techniques. These techniques are integrated into conventional surgical procedures to create new clinical protocols that are known as "digital surgical techniques". Conventional health care is characterized by subjective experiences, while digital medical technologies bring quantifiable information, transferable data, repeatable methods and predictable outcomes into clinical practices...
April 9, 2016: Zhonghua Kou Qiang Yi Xue za Zhi, Zhonghua Kouqiang Yixue Zazhi, Chinese Journal of Stomatology
Georgi Minchev, Gernot Kronreif, Mauricio Martínez-Moreno, Christian Dorfer, Alexander Micko, Aygül Mert, Barbara Kiesel, Georg Widhalm, Engelbert Knosp, Stefan Wolfsberger
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...
April 22, 2016: Journal of Neurosurgery
Dimitrios Paraskevopoulos, Jonathan Roth, Shlomi Constantini
OBJECTIVE: Cranial neuroendoscopy is becoming increasingly popular. Endoscopes may be used free-hand or with endoscope holders (EH). The aim of this paper is to summarize the evolution of EH and attempt an overview of currently available devices, features, and usage, identifying weaknesses and focusing on feasibility. METHODS: A systematic review was conducted on Pubmed, OvidSP, Ebsco, and Google Scholar. Targeted search through cross-references was also implemented, followed by personal contacts, interviews, company websites, and operating manuals...
May 2016: World Neurosurgery
Marco Aggravi, Elena De Momi, Francesco DiMeco, Francesco Cardinale, Giuseppe Casaceli, Marco Riva, Giancarlo Ferrigno, Domenico Prattichizzo
Haptics provides sensory stimuli that represent the interaction with a virtual or tele-manipulated object, and it is considered a valuable navigation and manipulation tool during tele-operated surgical procedures. Haptic feedback can be provided to the user via cutaneous information and kinesthetic feedback. Sensory subtraction removes the kinesthetic component of the haptic feedback, having only the cutaneous component provided to the user. Such a technique guarantees a stable haptic feedback loop, while it keeps the transparency of the tele-operation system high, which means that the system faithfully replicates and render back the user's directives...
August 2016: Medical & Biological Engineering & Computing
James Andrew Smith, Jamil Jivraj, Ronnie Wong, Victor Yang
This review provides an examination of contemporary neurosurgical robots and the developments that led to them. Improvements in localization, microsurgery and minimally invasive surgery have made robotic neurosurgery viable, as seen by the success of platforms such as the CyberKnife and neuromate. Neurosurgical robots can now perform specific surgical tasks such as skull-base drilling and craniotomies, as well as pedicle screw and cochlear electrode insertions. Growth trends in neurosurgical robotics are likely to continue but may be tempered by concerns over recent surgical robot recalls, commercially-driven surgeon training, and studies that show operational costs for surgical robotic procedures are often higher than traditional surgical methods...
April 2016: Annals of Biomedical Engineering
Ismail Ughratdar, Michael Samuel, Keyoumars Ashkan
Functional and stereotactic neurosurgery has always been regarded as a subspecialty based on and driven by technological advances. However until recently, the fundamentals of deep brain stimulation (DBS) hardware and software design had largely remained stagnant since its inception almost three decades ago. Recent improved understanding of disease processes in movement disorders as well clinician and patient demands has resulted in new avenues of development for DBS technology. This review describes new advances both related to hardware and software for neuromodulation...
2015: Journal of Parkinson's Disease
Christos Bergeles, Andrew H Gosline, Nikolay V Vasilyev, Patrick J Codd, Pedro J Del Nido, Pierre E Dupont
Concentric tube robots are catheter-sized continuum robots that are well suited for minimally invasive surgery inside confined body cavities. These robots are constructed from sets of pre-curved superelastic tubes and are capable of assuming complex 3D curves. The family of 3D curves that the robot can assume depends on the number, curvatures, lengths and stiffnesses of the tubes in its tube set. The robot design problem involves solving for a tube set that will produce the family of curves necessary to perform a surgical procedure...
February 3, 2015: IEEE Transactions on Robotics: a Publication of the IEEE Robotics and Automation Society
James J Doulgeris, Sabrina A Gonzalez-Blohm, Andreas K Filis, Thomas M Shea, Kamran Aghayev, Frank D Vrionis
BACKGROUND: Advances in technology have pushed the boundaries of neurosurgery. Surgeons play a major role in the neurosurgical field, but robotic systems challenge the current status quo. Robotic-assisted surgery has revolutionized several surgical fields, yet robotic-assisted neurosurgery is limited by available technology. METHODS: The literature on the current robotic systems in neurosurgery and the challenges and compromises of robotic design are reviewed and discussed...
July 2015: Cancer Control: Journal of the Moffitt Cancer Center
E Beretta, F Nessi, G Ferrigno, F Di Meco, A Perin, L Bello, G Casaceli, F Raneri, A De Benedictis, E De Momi
BACKGROUND: Cooperatively-controlled robotic assistance could provide increased positional accuracy and stable and safe tissue targeting tasks during open-skull neurosurgical procedures, which are currently performed free-hand. METHODS: Two enhanced torque-based impedance control approaches, i.e. a variable damping criterion and a force-feedback enhancement control, were proposed in combination with an image-based navigation system. Control systems were evaluated on brain-mimicking phantoms by 13 naive users and 8 neurosurgeons (4 novices and 4 experts)...
September 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Francisco J Fernandez-Nogueras Jimenez, Miguel Segura Fernandez-Nogueras, Majed Jouma Katati, Miguel Ángel Arraez Sanchez, Olga Roda Murillo, Indalecio Sánchez Montesinos
INTRODUCTION: The role of robotic surgery is well established in various specialties such as urology and general surgery, but not in others such as neurosurgery and otolaryngology. In the case of surgery of the skull base, it has just emerged from an experimental phase. OBJECTIVE: To investigate possible applications of the da Vinci surgical robot in transoral skull base surgery, comparing it with the authors' experience using conventional endoscopic transnasal surgery in the same region...
September 2015: Neurocirugía
Yaser Maddahi, Liu Shi Gan, Kourosh Zareinia, Sanju Lama, Nariman Sepehri, Garnette R Sutherland
BACKGROUND: A prerequisite for successful robot-assisted neurosurgery is to use a hand-controller matched with characteristics of real robotic microsurgery. This study reports quantified data pertaining to the required workspace and exerted forces of surgical tools during robot-assisted microsurgery. METHODS: A surgeon conducted four operations in which the neuroArm surgical system, an image-guided computer-assisted manipulator specifically designed to perform robot-assisted neurosurgery, was employed to surgically remove brain tumors...
September 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
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