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Updated: Oct 25, 2025
Building An Open-source Robotic Stereotaxic Instrument
Published on: October 29, 2013
Cranial neurosurgical robotics
Rami Elsabeh1, Sukhbir Singh1, Jeff Shasho2
1Brain and Spine Surgeons of New York, White Plains, NY, USA.
Object:
The purpose of this review is to highlight the major factors limiting the progress of robotics development in the field of cranial neurosurgery.
Methods:
A literature search was performed focused on published reports of any Neurosurgical technology developed for use in cranial neurosurgery. Technology was reviewed and assessed for strengths and weaknesses, use in patients and whether or not the project was active or closed.
Results:
Published reports of 24 robots are discussed going back to 1985. In total, there were 9 robots used in patients (PUMA, Robot Hand, EXPERT, Neuromate, Evolution 1, ROSA, iSYS1, NeuroArm and NeuRobot) and only 2 active today (ROSA, NeuroArm). Of all clinically active systems, only three were used in more than 30 patients (ROSA, iSYS1 & NeuroArm). Projects were limited by cost, technology adoption, and clinical utility to actually improve workflow. The most common use of developed robots is for Stereotaxis.
Conclusions:
There is a clear void in the area of cranial neurosurgery regarding robotics technology despite success in other fields of surgery. Significant factors such as cost, technology limitations, market size and regulatory pathway all contribute to a steep gradient for success.
