Global adoption of robotic technology into neurosurgical practice and research

Vittorio Stumpo,Carlo Serra,Aida Kafai Golahmadi,Anita M Klukowska,Victor E Staartjes,Pravesh S Gadjradj,Martin N Stienen,Anand Veeravagu,Marc L Schröder,Luca Regli

doi:10.1007/s10143-020-01445-6

Abstract

Recent technological advancements have led to the development and implementation of robotic surgery in several specialties, including neurosurgery. Our aim was to carry out a worldwide survey among neurosurgeons to assess the adoption of and attitude toward robotic technology in the neurosurgical operating room and to identify factors associated with use of robotic technology. The online survey was made up of nine or ten compulsory questions and was distributed via the European Association of the Neurosurgical Societies (EANS) and the Congress of Neurological Surgeons (CNS) in February and March 2018. From a total of 7280 neurosurgeons who were sent the survey, we received 406 answers, corresponding to a response rate of 5.6%, mostly from Europe and North America. Overall, 197 neurosurgeons (48.5%) reported having used robotic technology in clinical practice. The highest rates of adoption of robotics were observed for Europe (54%) and North America (51%). Apart from geographical region, only age under 30, female gender, and absence of a non-academic setting were significantly associated with clinical use of robotics. The Mazor family (32%) and ROSA (26%) robots were most commonly reported among robot users. Our study provides a worldwide overview of neurosurgical adoption of robotic technology. Almost half of the surveyed neurosurgeons reported having clinical experience with at least one robotic system. Ongoing and future trials should aim to clarify superiority or non-inferiority of neurosurgical robotic applications and balance these potential benefits with considerations on acquisition and maintenance costs.

Highlights

Neurosurgery is one of the most complex and delicate surgical specialties because of the limited maneuverability determined by the small surgical fields of modern minimally invasive approaches
Our aim was to carry out a worldwide survey among neurosurgeons to assess the adoption of and attitude toward robotic technology in the neurosurgical operating room, and to identify factors associated with use of robotic technology
The majority of respondents were in the 30–40 years age group (33%), and 88.7% of the answers were from male participants

Summary

Introduction

Neurosurgery is one of the most complex and delicate surgical specialties because of the limited maneuverability determined by the small surgical fields of modern minimally invasive approaches. Recent technological advancements have led to the development and implementation of robotic surgery in several specialties including general surgery, urology, gynecology, endocrine surgery, and orthopedics [2]. In this regard, neurosurgery—despite lagging behind the other specialties in terms of robotic applications because of its very technical peculiarities—constitutes no exception [1], and the practical application of robotic surgery is increasingly reported in the medical literature for the treatment of adult cranial [3], spinal [3,4,5], and pediatric pathologies [6]

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