The Silent Transformation of Stereotactic Brain Biopsies After the Introduction of Robotics

IF 2.3 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2025-07-05 DOI:10.1002/rcs.70087

Eliane Weinbrenner, Mykola Gorbachuk, Kathrin Machetanz, Florian Grimm, Linda Oberle, Sophie S. Wang, Marcos Tatagiba, Georgios Naros

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引用次数: 0

Abstract

Background

In frame-based stereotaxy, the design of the frame limits trajectory selection, e.g., to the temporal lobe and posterior fossa. We hypothesise that frame-less neuronavigation and robotic technology might have expanded these stereotactic corridors.

Methods

We analysed 376 frame-based, neuronavigated and robotic brain biopsies. We analysed entry (EP) and target (TP) point coordinates, trajectory lengths (TL) and angles (α₁,α₂), skin-to-skin time (STS), diagnostic yield and morbidity.

Results

Robotics liberated TP and EP selection, enabling trajectories not applicable with the frame. There was an increased application of lateral trajectories (reducing α1) while decreasing TL. There was a significant STS reduction attributable to a modification of the surgical approach (twist drill vs. burr hole).

Conclusions

Robotics modified trajectory selection and the surgical approach. Duration and invasiveness of brain biopsies were decreased without affecting diagnostic yield or morbidity. This may represent a clinical benefit of robotics compared with frame-based and frame-less stereotaxy.

Abstract Image

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机器人技术引入后立体定向脑活检的无声转变

在基于框架的立体定位中，框架的设计限制了轨迹的选择，例如，颞叶和后窝。我们假设，无框架神经导航和机器人技术可能扩大了这些立体定向走廊。方法对376例基于框架、神经导航和机器人的脑活检进行分析。我们分析了入点（EP）和靶点（TP）坐标、轨迹长度（TL）和角度（α1、α2）、皮肤对皮肤时间（STS）、诊断率和发病率。结果机器人解放了TP和EP的选择，使得不适用于框架的轨迹成为可能。在降低TL的同时，增加了侧向轨迹的应用（降低α1）。由于手术入路的改变（麻花钻vs毛刺孔），STS显著降低。结论机器人技术改进了手术入路选择和手术入路。在不影响诊断率和发病率的情况下，脑部活检的时间和侵入性降低。与基于框架和无框架立体定位相比，这可能代表了机器人技术的临床优势。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.