Robotics in the neurosurgical treatment of glioma.
BACKGROUND
The treatment of glioma remains a significant challenge with high recurrence rates, morbidity, and mortality. Merging image guided robotic technology with microsurgery adds a new dimension as they relate to surgical ergonomics, patient safety, precision, and accuracy.


METHODS
An image-guided robot, called neuroArm, has been integrated into the neurosurgical operating room, and used to augment the surgical treatment of glioma in 18 patients. A case study illustrates the specialized technical features of a teleoperated robotic system that could well enhance the performance of surgery. Furthermore, unique positional and force information of the bipolar forceps during surgery were recorded and analyzed.


RESULTS
The workspace of the bipolar forceps in this robot-assisted glioma resection was found to be 25 × 50 × 50 mm. Maximum values of the force components were 1.37, 1.84, and 2.01 N along x, y, and z axes, respectively. The maximum total force was 2.45 N. The results indicate that the majority of the applied forces were less than 0.6 N.


CONCLUSIONS
Robotic surgical systems can potentially increase safety and performance of surgical operation via novel features such as virtual fixtures, augmented force feedback, and haptic high-force warning system. The case study using neuroArm robot to resect a glioma, for the first time, showed the positional information of surgeon's hand movement and tool-tissue interaction forces.
Project NeuroArm, Department of Clinical Neuroscience and The Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada.
Garnette R
GR
Sutherland
Project NeuroArm, Department of Clinical Neuroscience and The Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada.
Yaser
Y
Maddahi
Project NeuroArm, Department of Clinical Neuroscience and The Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada.
Liu Shi
LS
Gan
Project NeuroArm, Department of Clinical Neuroscience and The Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada.
Sanju
S
Lama
Project NeuroArm, Department of Clinical Neuroscience and The Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4Z6, Canada.
Kourosh
K
Zareinia
Force feedback; glioma; haptic warning; intraoperative magnetic resonance imaging; robot-assisted microsurgery; virtual fixture