The analysis of intraoperative neurosurgical instrument movement using a navigation log-file.
BACKGROUND
The purpose of this study was to define the technical requirements of future (tele)robotic neurosurgical systems. We aimed to analyse the movements of surgical instruments during neurosurgical procedures.


METHODS
A commercially available neuronavigation system (StealthStation TREON(plus), Medtronic, USA) was used to determine the position and orientation of the surgical instrument. A custom-made log-mode was implemented in the software to file instrument coordinates intraoperatively. Data was collected during the debulking of malignant primary brain tumours, temporal epilepsy surgery and skull base tumour surgery.


RESULTS
Maximum tip displacement velocity varied, per procedure, in the range 6.6-12.7 cm/s and maximum rotational speed 21-40 degrees/s. Maximum instrument orientation differences within the volume of movement varied. The largest differences were detected during temporal epilepsy surgery (73 degrees and 52 degrees in the coronal and axial planes, respectively), while the smallest differences were detected in the debulking of an intraventricular tumour.


CONCLUSIONS
In this study, we have demonstrated the feasibility of motion analysis in image-guided neurosurgery. To mimic ordinary open neurosurgery, future neurosurgical (tele)robotic systems should at least support translational speeds up to 12.7 cm/s, rotational speeds up to 40 degrees/s and differences in instrument orientation of up to 73 degrees.
Woerdeman
P A
PA
Rudolf Magnus Institute of Neuroscience, Department of Neurosurgery, University Medical Center Utrecht, The Netherlands. p.a.woerdeman@neuro.azu.nl
Willems
P W A
PW
Noordmans
H J
HJ
van der Sprenkel
J W Berkelbach
JW
D016208:Databases, Factual; D019544:Equipment Failure Analysis / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D016247:Information Storage and Retrieval / Q000379:methods*; D007430:Intraoperative Care / Q000295:instrumentation / Q000379:methods; D009038:Motion; D038361:Neuronavigation / Q000295:instrumentation* / Q000379:methods; D015203:Reproducibility of Results; D012371:Robotics / Q000295:instrumentation* / Q000379:methods; D012680:Sensitivity and Specificity; D013647:Task Performance and Analysis