Robot-based Registration and Navigation for Neurosurgery

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Brain ailments may have to be often treated with surgery. Neurosurgery demands special skills in terms of insight, accuracy, alertness, and navigation control. Though humans attain these qualities, there exist complications associated with open brain surgery or craniotomy. The option to isolate the problem region from the rest and execute minimum invasion will lessen the complications. In Minimally Invasive Surgery (MIS), the surgical task can be performed through a small burr hole drilled on the skull of the patient. Less risk, minimum invasion, reduced healing time, and fewer chances of the infection are some of the benefits of the MIS. In conjunction with these advantages, MIS has some downsides like narrowing of the field of view of the surgeon and difficulty in tool handling through a burr hole. MIS often coupled with stereotactic neurosurgery, where the 3D coordinate system is utilized to locate the problem region and to navigate the surgical tool within the brain. The accuracy of frame-based stereotactic neurosurgery is high compared to the frameless method but lacks in patient comfort. Generally, the frameless system works in combination with a stereo camera. The stereo camera, mounted at the Operation Theatre (OT), continuously tracks the surgical tool by computing the location of reflective markers attached to the tool. The reflective markers should always be visible to the stereo camera to avoid the line of sight problem. The frameless robot-based neurosurgery is a stereotactic MIS. It takes care of patient comfort and enhances the possibilities of the MIS by providing detailed internal visualization through multiple cross-sectional images, 3D patient-specific model, and real-time tracking of the surgical tool. Further, it can achieve better accuracy, higher repeatability, tremor free operation, and highly focused miniature surgery. The overall accuracy of robot-based neurosurgery depends on many factors like robot accuracy, imaging accuracy, the measurement accuracy of reference points in medical image space as well as robots' space. Majorly the neuro-registration method and the practice play a vital role in achieving high accuracy in neurosurgery.

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