28 - Robotics in Cranial Neurosurgery

Abstract

Technological advances over the past two decades have contributed to the increasing role of robotics in a variety of industries, and several robotic systems have emerged as highly developed, integrated surgical tools in surgical subspecialties including urology, gynecology, head and neck surgery, colorectal surgery, cardiac surgery, and thoracic surgery. The robots currently used in these fields represent mature and highly dynamic assistive, though not yet autonomous systems. They combine advanced visualization techniques with minimal-access capabilities and versatile, multi-armed systems equipped with various tools, degrees of freedom not available to human hands, motion scaling and tremor correction, and some rudimentary forms of artificial intelligence. The robotic systems currently available for use in neurosurgery are more primitive and more limited in their utility. In both spinal and cranial neurosurgical applications, surgical robots are predominantly limited to static, stereotactic functions, guiding the surgeon to a trajectory but stopping short of assisting the neurosurgeon in a dynamic, cooperative manner. In this chapter, we begin by discussing several dominant robotic systems and technologies in current surgical use and other systems in advanced stages of research and development. We then review core principles of robotics as applicable to surgery. Finally, we address important factors limiting the progress of robotics in cranial neurosurgery. The era of robotic surgery has arrived, and future editions will undoubtedly see progressive development in this area.