NEUROSURGICAL ROBOTS

  • Emeritus Professor of Neurosurgery, Universidad Autónoma de Madrid
  • Head of Neurosurgical Department, Hospital Rosario, Madrid

R. GARCIA DE SOLA

INNOVATION

NEUROSURGERY

IN

A: PRE-SURGICAL IMAGES 

MRi 3T CT-scan

B: NEURONAVIGATION

MRi Tractography

Pre

Post

C: Intraoperative Neurophysiological

Anatomo-Functional Correlation

Monitoring (IONM)

NEURONAVIGATION + IONM

Trans-sulcal Approach

Pre-operative

Post-operative

D: VISION

Microscope Fluorescence * 5-ALA

D: VISION

Endoscope:

  • Skull Base Surgery
  • Endoscope-Assisted Microsurgery

  • Hands-on in Cadaver

ROBOT

ROBOT

E: ROBOT

Personal background

MICROscope

roBOT

MICROBOT ®

E: ROBOT

Personal background

PATENT: Passive Robotic Arm

Movement disorders

E: ROBOT

Characteristics:

- Controlled movements

- Spatial Awareness

- Steadiness

- Accuracy

E: ROBOT

Main types in robotic surgery: 

- Slave: Da VINCI

E: ROBOT

Main types in robotic surgery: 

  - Assistant: ROSA (RObotic Surgical Assistant)

The "utopian" operating room

Combining of the biggest advances

A: Images

B: Neuronavigation

C: VISION

  • microscope
  • endoscope

D: IONM

E: Robot

The "utopian" operating room

A: New designs

- Zeiss-BrainLab

- Synactive

The "utopian" operating room

A: Features of my operation room

- ROSA Robot Endoscope

- Images

- Neuronavigation

- Microscope

Applications

A: Endoscopic-assisted Microsurgery

  A1.- Control of resection

Applications

A: Endoscopic-assisted Microsurgery

  A2: Microscope - Endoscope

-  Simultaneous

- Interchangeable

- No risk

of tiredness

Applications

A: Endoscopic-assisted Microsurgery

  A3: Last state of resection

Applications

B: Endoscopic approaches

  A3: Last state of resection

Robotized Endoscopy

Main advantages

  • Steadiness

  • Vision of exact anatomic placement of the tip of the endoscope

  • Controlled and precise movements

  • Sitting position

  • 3-4 free-handed approach

Disadvantages

  • Time-consuming ?

  • Head fixation

  • Less three-dimensional sensation

CONCLUSIONS

Robotic Technology

  • Beginning to be applied in Neurosurgery

    • Successfully

    • User-Friendly

  • A support of endoscopy

CONCLUSIONS

ROSA robot as a support of Endoscopy

  • Main applications

    • Control of microsurgical resections

    • Use alongside the microscope
      Successfully

CONCLUSIONS

ROSA robot as a support of Endoscopy

  • Main applications

    • Endoscopic approaches

      • Holding the endoscope

      • Neuronavigation

      • Accurate movements

INNOVATION

I - Key aspects

  • Technological advances have generally been developed by outstanding neurosurgeons.

  • This new technology has made it possible for these neurosurgeons to overcome limitations and pioneer new surgical advances.

  • When “normal” neurosurgeons become familiar with this technology  they, like the innovators, will also improve their performance and achieve results above the average

A process of continuous evolution

INNOVATION

II - Harmony in the Operating Theatre

  • Exact location for each piece of equipment

  • Trained surgical team

A process of continuous evolution

THANK YOU

neurorgs.net

innovation in neurosurgery

By Jesús R. Ortega

innovation in neurosurgery

NEUROSURGICAL ROBOTS.R. GARCIA DE SOLA Emeritus Professor of Neurosurgery, Chairman of UAM Innovation in Neurosurgery Department, Universidad Autónoma de Madrid Head of Neurosurgical Department, Hospital Rosario, Madrid

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