Evaluation of a neurosurgical robotic system to make accurate burr holes

Neurosurgery has been driven forward by the latest breakthroughs in technology that combine science and engineering. Neurosurgical robotic systems are a good example of such a breakthrough that has several potential advantages over existing techniques. This study sought to evaluate the Pathfinder robotic system in order to establish whether it is capable of carrying out burr hole procedures in specific locations in human skull replicas, along predetermined trajectories and for precise depths.

Three different registration fiducial configurations (A, B and C) were used on three different skull replicas of patients obtained from CT scan reconstructions. The skull replicas were scanned and the PathFinder robotic arm was used to place burr holes along specific trajectories. Target registration accuracies for surface targets and burr hole placements were measured, and the burr hole depths and trajectories were assessed.

Overall registration errors, surface target registration accuracies, and burr hole target registration accuracies were submillimetric in all three registration fiducial configurations. However, the accuracies recorded in configurations B and C were significantly better than those in configuration A.

Results demonstrated that the robotic system can approach surface and burr hole targets accurately. The accuracy was altered significantly by the configuration of registration fiducials and the robot was a useful tool to steady the surgical drill to place burr holes in specific locations and depth along the programmed trajectory.