The increasing need for greater magnification and smaller tools has made the human hand unfeasible to perform the tasks. Improvements in computer technology, engineering, minimum invasive surgery, along with the new neuroimaging techniques, created the concept of digital robotic neurosurgery and such technologies have enabled surgeon to work with more accuracy and better microscopic relevancy levels. In the 1985s, the Programmable Universal Machine for Assembly industrial robot (PUMA) was the first time a robot was ever used for neurosurgery. The surgeon inputted the x-y coordinates on a probe based on a preoperative image of an intracranial lesion. Though the device lacked enough safety features, its potential highly excited scientists all over the world and robots increasing took center stage in frame-based stereotactic (precise) head surgeries.
In 1991, the University of Lausanne in Switzerland invented the Minerva which was the first system to provide image guidance in real-time, allowing the surgeon to change direction as the brain moved, resulting in real-time localization of surgical instrumentation in corresponding images of the patient, and this is what later developed into the current high-tech robotic surgical machine
Using robotics for neurosurgical practice provides the surgeon with many advantages. The most important advantages pertaining to neurosurgery are the ability to perform microsurgeries, increase accuracy and precision, access to small corridors (minimally invasive surgery), the ability to process large amounts of data (image-guided surgery), the ability for tele-surgery (making surgery by remote control), and deducing the surgeon’s physiological tremor. This is particularly important to the brain because all the tissue of the organ is very delicate.
The first Robotic tele-collaboration in brain surgery was done on 23rd Sep 2002 at Saint John Regional Hospital in New Brunswick. The tele-surgical operation was given a robotic support at a distance of 400km away from the scene of operation from Halifax, Nova Scotia- Canada. In this operation, a tumor was successfully removed from the brain using the SOCRATES tele-collaboration System. This great achievement was reached at using a NeuRobot. The NeuRobot is a tele-controlled microscopic micromanipulator system designed for neurosurgical procedures. The unit houses a three-dimensional endoscope and three robot arms that the surgeon operates without direct contact with the patient.
A basic neurosurgical robot consists of the following components: robotic arm, feedback sensors, controllers which instruct the robot (end-effector), a wireless localization system and a data processing center (the brain).The end-effector is able to control the robotic arm and use tools such as a probe, endoscope, or retractor. The tool can usually be manipulated with 6 of freedom. Sensors provide the surgeon with the necessary feedback from the surgical site, which is processed by the computer, returning information such as the location of a tool within a site.
Neurosurgery is particularly demanding, as the brain is arguably the most complicated object in the known universe and this coupled with the cost-to-benefit ratio, the procedures would generally be too expensive for the hospital to invest in for the rather simple tasks and poor-decision-making capabilities of the robot. This remains the major limitations to such technologies that would greatly change the terrain of health care in the world.
