Neurosurgical robotic arm drilling navigation system

Stereotactic Neuro-Navigation Phantom Designs: A Systematic Review

Diverse stereotactic neuro-navigation systems are used daily in neurosurgery and novel systems are continuously being developed. Prior to clinical implementation of new surgical tools, methods or instruments, in vitro experiments on phantoms should be conducted. A stereotactic neuro-navigation phantom denotes a rigid or deformable structure resembling the cranium with the intracranial area. The use of phantoms is essential for the testing of complete procedures and their workflows, as well as for the final validation of the application accuracy. The aim of this study is to provide a systematic review of stereotactic neuro-navigation phantom designs, to identify their most relevant features, and to identify methodologies for measuring the target point error, the entry point error, and the angular error (α). The literature on phantom designs used for evaluating the accuracy of stereotactic neuro-navigation systems, i.e., robotic navigation systems, stereotactic frames, frameless navigation systems, and aiming devices, was searched. Eligible articles among the articles written in English in the period 2000-2020 were identified through the electronic databases PubMed, IEEE, Web of Science, and Scopus. The majority of phantom designs presented in those articles provide a suitable methodology for measuring the target point error, while there is a lack of objective measurements of the entry point error and angular error. We identified the need for a universal phantom design, which would be compatible with most common imaging techniques (e.g., computed tomography and magnetic resonance imaging) and suitable for simultaneous measurement of the target point, entry point, and angular errors.

Cranial Perforation Using an Optically-Enhanced Surgical Drill

The design of mechanically clutched cranial perforators, used in craniotomy procedures, limits their performance under certain clinical conditions and can, in some cases, impose the risk of severe brain injury on patients undergoing the procedure. An additional safety mechanism could help in mitigating these risks. In this work, we examine the use of diffuse reflectance spectroscopy as a potential fallback mechanism for near real-time detection of the bone-brain boundary. Monte Carlo simulation of a two layer model with optical properties of bone and brain at 530 and 850 nm resulted in a detectable change in diffuse reflectance signal when approaching the boundary. The simulated results were used to guide the development of an experimental drill control system, which was tested on 10 sheep craniums and yielded 88.1 % success rate in the detection of the approaching bone-brain boundary.