Robotics in Neurosurgery: Applications, Techniques, and Clinical Benefits

Introduction

Improving safety and efficiency in the operating room has been the driving force behind technological advancements within the surgical suite. Development of minimally invasive surgical techniques has played a large role in this endeavor, with the first minimally invasive surgery being a laparoscopic cholecystectomy performed in 1987. The benefits of decreased surgical infection rates, shorter hospital stays, and lower postoperative opioid usage were soon realized. Adoption of minimally invasive techniques was slowed by the associated learning curve, and soon innovators in private industry and the medical field alike sought to ease the learning process by developing robots for the operating room. Today, robotics are utilized widely in many surgical subspecialties, including urology, gynecology, and general surgery. Application of robotics to neurosurgery first came in 1985 when the Programmable Universal Machine for Assembly (PUMA) 560 was used to perform a brain biopsy. However, this failed to receive widespread acceptance secondary to cost and skepticism regarding its utility. As robotic applications grew in other surgical specialties, advancements in intraoperative cranial and spinal neurosurgical imaging techniques grew in parallel; these have helped minimize human error in the navigation of often distorted or obscured anatomy, whether that distortion is due to oncologic, traumatic, or degenerative pathologies. The expansion of intraoperative imaging techniques served as a catalyst for the reintroduction of robotics into the neurosurgical OR. Today, multiple robotic platforms are being adopted across the country to increase the efficiency and safety of neurosurgical practice. This chapter aims at providing an overview of the indications, techniques, and clinical benefits of robotic neurosurgery.

This chapter can be found online at expertconsult.com .