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