Handheld robotic device for endoscopic neurosurgery: system integration and pre-clinical evaluation

Area of Science:

• Neurosurgery
• Robotics
• Medical Devices

Background:

• The Expanded Endoscopic Endonasal Approach (EEA) provides skull base access via the nostril.
• Current endoscopic neurosurgery instruments have limited articulation, restricting surgeon dexterity and operative reach.
• Robotic articulation could significantly enhance performance in EEA procedures.

Purpose of the Study:

• To present a novel handheld robotic system with articulated instruments for the Expanded Endoscopic Endonasal Approach.
• To evaluate the system's workspace, structural integrity, and force-delivery capabilities.
• To assess the system's feasibility and performance in pre-clinical and cadaveric studies.

Main Methods:

• Development of a handheld robotic system with interchangeable 3 mm articulated instruments (2/3 degrees-of-freedom).
• Experimental evaluation of instrument workspace, structural integrity, and force-delivery.
• Pre-clinical phantom feasibility testing.
• Cadaveric pilot study involving surgeons with varying experience levels.

Main Results:

• Robotic instruments demonstrated expanded workspace and enhanced surgeon dexterity.
• The system exhibited adequate structural integrity and force-delivery capabilities.
• Cadaveric studies indicated feasibility for clinical application and improvement over standard instruments.

Conclusions:

• The presented handheld robotic system shows promise for enhancing dexterity and expanding the operative workspace in endoscopic neurosurgery.
• The system's performance in pre-clinical and cadaveric evaluations suggests potential for clinical adoption in skull base surgery.
• This robotic approach offers a significant advancement over current neurosurgical instrumentation for the EEA.