Design and use of assistant robotic arm in endoscopic transnasal surgery
This study aimed to develop a robotic system with autonomous functionality for holding and manipulating the endoscope in endoscopic endonasal surgery. A cost-effective prototype was created with the goal of using robotic assistance and achieving a more efficient learning curve for endoscopic surgery.
Accuracy and safety evaluation of a novel artificial intelligence-based robotic system for autonomous spinal posterior decompression
This study aimed to introduce a novel artificial intelligence (AI)-based robotic system for autonomous planning of spinal posterior decompression and verify its accuracy through a cadaveric model.
Comparison between robot-assisted and navigation-guided minimally invasive transforaminal lumbar interbody fusion: a multicenter study
Both robot and computer navigation have significantly improved the accuracy and safety of percutaneous pedicle screw placement compared with a freehand fluoroscopy-guided technique. However, how the two new technologies compare with each other is unknown. The aim of this study was to investigate the accuracy and safety of robot-assisted and navigation-guided percutaneous pedicle screw placement in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).
Limitations of current robot-assisted pedicle screw insertion systems
As robot systems for spine surgery have been developed, they have demonstrated a high degree of accuracy in screw placement without sacrificing safety or surgical efficiency. These robotic systems offer preoperative planning and real-time feedback to enhance surgical precision and mitigate human error. Nevertheless, limitations to their optimal performance remain. The authors analyzed the initial 100 cases of pedicle screw placements performed using the Mazor X robot at their institution, presenting case examples to illustrate the limitations that were experienced, and reviewed current literature on the limitations of robot-assisted spine surgery, emphasizing their impact on accuracy and safety.
Irradiation safety, anesthesia time, surgical complications, and patient-reported outcomes in the robotic Mazor X versus fluoroscopy guided minimally invasive transforaminal lumbar interbody fusion surgery: a comparative cohort study
Robot-assisted (RA) technology is becoming more widely integrated and accepted in spine surgery. The authors sought to evaluate operative and patient-reported outcomes (PROs) in RA versus fluoroscopy-assisted (FA) pedicle screw placement during minimally invasive surgery (MIS) transforaminal lumbar interbody fusion (TLIF).
Microvascular decompression in trigeminal neuralgia using a robot-assisted exoscope and head-mounted display
Microvascular decompression (MVD) in trigeminal neuralgia (TN) is currently managed using an operating microscope (OM). Recent experiences with endoscopy-assisted, fully endoscopic, and exoscopic surgery have been described, aiming to improve ergonomics and image quality. The aim of this study was to report the first series of patients operated on with the aid of a robotic binocular exoscope using a head-mounted display (RoboticScope).
Accuracy of cervical pedicle screw placement with a robotic guidance system via the open midline approach
An increasing number of studies have shown that a robotic guidance system (RGS) can provide accurate cervical pedicle screw (CPS) placement. The accuracy of CPS placement with an RGS has mostly been evaluated according to the magnitude of pedicular cortical violation. However, an RGS assists in pedicle screw (PS) placement by directly indicating the preplanned trajectory in the operative field. Therefore, investigating how accurately the planned trajectory is executed is essential to determine the accuracy of CPS placement using an RGS, in addition to evaluating the clinical accuracy. Hence, this study aimed to evaluate the accuracy of CPS placement using an RGS by comparing the executed trajectory with the planned trajectory.
Integration of a lightweight and table-mounted robotic alignment tool with automated patient-to-image registration using robotic cone-beam CT for intracranial biopsies and stereotactic electroencephalography
Robotics in neurosurgery is becoming increasingly prevalent. The integration of intraoperative imaging for patient registration into workflows of newer robotic systems enhances precision and has further driven their widespread adoption. In this study, the authors report on a lightweight, table-mounted robotic system integrating robotic cone-beam CT (CB-CT) for automated patient registration in cranial biopsies and stereotactic electroencephalography (sEEG).
Robotic carotid artery stenting: a multicenter, propensity score-matched analysis of clinical outcomes and cost-effectiveness
Preclinical studies suggest that robotic carotid artery stenting (CAS) could be superior to manual CAS. However, very limited comparative data exist for patients who have undergone robotic versus manual CAS. In addition, no data exist comparing the costs of manual and robotic CAS.
Predictors of cost of admission for robot-assisted pedicle screw placement
The authors investigated the predictors of cost of admission (CoA) for robot-assisted pedicle screw placement to assess the value of robotic systems in spine operations.
Design, fabrication, and testing of a new soft-pouch robot with 6 degrees of freedom to expand the reach of open and endonasal skull base approaches
Most robots currently used in neurosurgery aid surgeons in placing spinal hardware and guiding electrodes and biopsy probes toward brain targets. These robots are inflexible, cannot turn corners, and exert excessive force when dissecting and retracting brain tissue, limiting their applicability in cranial base surgery. In this study, the authors present a novel soft-pouch robot prototype driven by compressed air and capable of gentle tissue manipulation. The robot is manufactured with technology developed by the authors, with multiple bidirectional bending points and a miniature camera running through the robot's central channel.
Neuro-oncology application of next-generation, optically tracked robotic stereotaxis with intraoperative computed tomography: a pilot experience
Innovations in robotics continue to reshape the landscape of neurosurgery. Here, the authors evaluated the safety and efficacy of the ExcelsiusGPS robot in the treatment of neuro-oncological, intracranial lesions.
Feasibility of robotic posterior fossa skull base surgery
Despite its potential advantages, robotic surgery has yet to be applied to skull base procedures. Complex anatomy and restricted access have limited the development of robotic skull base surgery. The authors' aim was to conduct a feasibility study of robotic surgery for posterior fossa skull base lesions.
The safety, accuracy, and feasibility of robotic assistance in neuro-oncological surgery
Over the past 3 decades, robotic technology has advanced significantly across surgical fields, driven by improvements in versatility, stability, skill, and tactile properties. Neurosurgery has led the way in integrating robotics to improve the accuracy and safety of procedures that require high precision. This study aimed to present one of the largest series in the literature and investigate the feasibility and effectiveness of robotic assistance in neuro-oncological surgery.
Robot-assisted stylomastoid foramen puncture and radiofrequency ablation for hemifacial spasm treatment: clinical outcomes and technique assessment
Stylomastoid foramen (SMF) puncture with radiofrequency ablation (RFA) is a minimally invasive therapy for hemifacial spasm (HFS) with notable therapeutic outcomes. Conventionally, this procedure is performed under CT guidance. The present study highlights the authors' preliminary clinical experience with robot-assisted SMF puncture in 7 patients with HFS using a neurosurgical robot.
Indication-based analysis of laser interstitial thermal therapy: a propensity score-matched comparison of outcomes for brain tumor versus epilepsy indications
Laser interstitial thermal therapy (LITT) is a minimally invasive procedure used to ablate abnormal tissue in a targeted fashion. It is most commonly used to treat epileptic foci, brain tumors, and radiation necrosis. This study aimed to compare immediate postoperative outcomes between these indications.
Introduction. Calibrating the utility of laser interstitial thermal therapy in neurosurgery: a once-novel surgical treatment finds it place in the armamentarium
Letter to the Editor. Management and long-term neurological outcomes of sdAVF
Editorial. Factors that influence functional recovery after MR-guided laser interstitial thermal therapy for recurrent high-grade gliomas
Stereotactic robot-assisted MRI-guided laser interstitial thermal therapy thalamotomy for medically intractable Holmes tremor: a pilot study and literature review
Holmes tremor (HT) is a complex syndrome characterized by resting, postural, and kinetic tremors. HT significantly impacts patients' quality of life (QOL) and daily activities. Conventional pharmacological treatments for HT often yield inconsistent results. Emerging surgical treatments such as deep brain stimulation and various thalamotomy techniques show promise but come with challenges, including adverse events (AEs) and potential tremor recurrence. This study aimed to evaluate the clinical outcomes of unilateral MRI-guided laser interstitial thermal therapy (MRIgLITT) thalamotomy in patients with medically intractable HT, focusing on tremor reduction, QOL, and AE incidence, and provide a comprehensive review of the literature on thalamotomy techniques for HT.