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Updated: Mar 3, 2026

Building An Open-source Robotic Stereotaxic Instrument
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Computer-aided design/computer-aided manufacturing skull base drill.

William T Couldwell1, Joel D MacDonald1, Charles L Thomas2

  • 1Departments of Neurosurgery and.

Neurosurgical Focus
|May 3, 2017
PubMed
Summary

A new computer-aided design/computer-aided manufacturing (CAD-CAM) device guides surgical bone drilling. This image-guided system enhances precision, potentially reducing surgical time and complications in neurosurgery.

Keywords:
CAD-CAMCAD-CAM = computer-aided design/computer-aided manufacturingCNC = computer numerical controlledcomputer-aided design/computer-aided manufacturingskull basesurgical drill

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Area of Science:

  • Neurosurgery
  • Medical Device Technology
  • Surgical Robotics

Background:

  • Computer-aided design/computer-aided manufacturing (CAD-CAM) systems are increasingly integrated into surgical planning and execution.
  • Image guidance is crucial for precise localization and navigation during complex neurosurgical procedures.
  • Accurate bone removal is essential in cranial and spine surgeries to access target pathologies while preserving critical structures.

Purpose of the Study:

  • To develop and validate a novel CAD-CAM device for image-guided bone drilling in neurosurgery.
  • To assess the device's potential to optimize cutting tool paths and improve surgical efficiency.
  • To evaluate the accuracy and safety of the system in proximity to vital anatomical structures.

Main Methods:

  • Utilizing 2D imaging data (CT/MRI) to generate a 3D model of the surgical site.
  • Employing an image-guided system to define an optimized cutting tool path.
  • Transmitting the generated tool path code to a surgical machining system for automated bone drilling.

Main Results:

  • The device successfully generated precise cutting tool paths for bone removal.
  • Demonstrated rapid bone removal (< 3 minutes) with accuracy within 1 mm of vital structures.
  • Validated efficacy in transtemporal (translabyrinthine) approaches, highlighting potential for cranial and spine neurosurgery.

Conclusions:

  • The developed CAD-CAM device offers a safe and efficient solution for image-guided bone drilling in neurosurgery.
  • This technology has the potential to significantly reduce surgical duration and associated risks like infection and blood loss.
  • The system's precision and speed indicate a promising advancement for neurosurgical bone removal techniques.