Handheld Robotic Device for Endoscopic Neurosurgery: System Integration and Pre-clinical Evaluation Provisionally Accepted
- 1Wellcome-EPSRC Centre for Interventional and Surgical Sciences, University College London, United Kingdom
- 2Other, United Kingdom
- 3National Hospital for Neurology and Neurosurgery (NHNN), United Kingdom
The Expanded Endoscopic Endonasal Approach, one of the best examples of endoscopic neurosurgery, allows access to the skull base through the natural orifice of the nostril. Current standard instruments lack articulation limiting operative access and surgeon dexterity, and thus, could benefit from robotic articulation. In this study, a handheld robotic system with a series of detachable end-effectors for this approach is presented. This system is comprised of interchangeable articulated 2/3 degrees-of-freedom 3mm instruments that expand the operative workspace and enhance the surgeon's dexterity, an ergonomically designed handheld controller with a rotating joystick-body that can be placed at the position most comfortable for the user, and the accompanying control box. The robotic instruments were experimentally evaluated for their workspace, structural integrity, and force-delivery capabilities. The entire system was then tested in a pre-clinical context during a phantom feasibility test, followed up by a cadaveric pilot study by a cohort of surgeons of varied clinical experience. Results from this series of experiments suggested enhanced dexterity and adequate robustness that could be associated with feasibility in a clinical context, as well as improvement over current neurosurgical instruments.
Keywords: medical robotics, handheld robotics, Robotic neurosurgery, endoscopic neurosurgery, Endonasal approach
Received: 12 Mar 2024;
Accepted: 13 May 2024.
Copyright: © 2024 Dimitrakakis, Dwyer, Newall, Khan, Marcus and Stoyanov. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dr. Emmanouil Dimitrakakis, Wellcome-EPSRC Centre for Interventional and Surgical Sciences, University College London, London, WC1E 6BT, England, United Kingdom