Abstract

Background:The treatment of glioma remains a significant challenge with high recurrence rates, morbidity, and mortality. Merging image guided robotic technology with microsurgery adds a new dimension as they relate to surgical ergonomics, patient safety, precision, and accuracy.Methods:An image-guided robot, called neuroArm, has been integrated into the neurosurgical operating room, and used to augment the surgical treatment of glioma in 18 patients. A case study illustrates the specialized technical features of a teleoperated robotic system that could well enhance the performance of surgery. Furthermore, unique positional and force information of the bipolar forceps during surgery were recorded and analyzed.Results:The workspace of the bipolar forceps in this robot-assisted glioma resection was found to be 25 × 50 × 50 mm. Maximum values of the force components were 1.37, 1.84, and 2.01 N along x, y, and z axes, respectively. The maximum total force was 2.45 N. The results indicate that the majority of the applied forces were less than 0.6 N.Conclusion:Robotic surgical systems can potentially increase safety and performance of surgical operation via novel features such as virtual fixtures, augmented force feedback, and haptic high-force warning system. The case study using neuroArm robot to resect a glioma, for the first time, showed the positional information of surgeon's hand movement and tool-tissue interaction forces.

Highlights

  • The treatment of glioma remains a significant challenge with high recurrence rates, morbidity, and mortality

  • Notwithstanding significant challenges, this problem could be rectified by providing robotic surgical tools not limited by the line of sight while able to bend around corners, for example, a snake‐like mechanism, during functional MRI in an awake patient.[43]

  • As imaging and microsurgery could be performed at the same time using an MR compatible robotic system, the tool‐tip could be well positioned for resection of residual tumor adjacent to speech cortex and its connections

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Summary

Methods

An image‐guided robot, called neuroArm, has been integrated into the neurosurgical operating room, and used to augment the surgical treatment of glioma in 18 patients. A case study illustrates the specialized technical features of a teleoperated robotic system that could well enhance the performance of surgery. Unique positional and force information of the bipolar forceps during surgery were recorded and analyzed

Results
Conclusion
Technical methods to increase safety
RESULTS
CONCLUSIONS
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