Updated: Aug 26, 1998
This is the most recent structured information on this project. Complementary data can be found on previous documents
ROBOSCOPE Ultrasound-Image-Guided Manipulator-Assisted System for Minimally Invasive Endo-Neurosurgery

Overview

Purpose and objectives

Project summary

1. intraoperative imaging to guide the surgeon in the tiny operating field and to correct for shifts of the brain and of its compartments due to operative manipulations (to be achieved by 3 D ultrasound imaging with a ring-or disc-shaped probe in the trepanation),

2. complex image-fusion facilities in a surgeon´s workstation, using pre- and intraoperative image-information,

3. Fully co-registered manipulator arm ROBOMATE for high-dexterity tasks. High-end visualisation of preoperative images will serve for training and simulation of operations with the manipulator arm (ROBO-SIM). The cost-factor is accounted-for by using ultrasound instead of MRI and by adapting and improving an existing robot-system, which has been found acceptable for microsurgical purposes in neurosurgery.

Modules of the system will be applicable in neurosurgery and in other areas of medicine. In several European countries, considerable expertise has accumulated to solve the scientific challenges of this project. Industrial production and commercial distribution of the products are strived for by companies with international reputation in their fields. Following composition of the experimental prototype on the integration platform, testing and peer-reviewing of components and the integral system ROBOSCOPE is performed by the most renowned surgical specialists in endo-neurosurgery worldwide.

Objectives of the Project

Robotic and software control structures will be adapted to provide the active constraint facility. This will require integration with the Surgeon/ Computer interface as well as with the robot platform.

The components developed in this project will be physically brought together during the last phase on an integration platform. The integral system with several screen displays and the robot-arm fixated to the operating table, will consist of 1.- software-tools for multi-modality image fusion (3D-CT and -MRI as well as functional MRI and 2D-angiography) and for high-end visualisation of datasets of the brain, 2.- 3D ultrasound imaging for intraoperative application, 3.- a manipulator arm with robotic capabilities for burrhole-procedures in neurosurgery. These three components will be built for user-friendly co-registration of spaces on a surgeon´s workstation; the computer of this workstation will allow to use high-end visualisation-tools developed and/or adapted for the planning and simulation of surgery. Components 1 and 3 may be used with the robot mounted on a simulation stand so as to make the unit a surgical simulator - ROBO-SIM, where 3D-reconstructions and virtual endoscopic views may be used for visualisation of simulated surgical steps. This surgical simulator ROBO-SIM will provide anatomical orientation on surgical approaches and in the immediate microsurgical environment.

The complete ROBOSCOPE unit shall enable the neurosurgeon to simulate planning and performance of a burrhole procedure in a dummy- or anatomical model, e.g. by using a preoperative 3D-MR-dataset for planning of the approach track to a target, which could be a simulated ventricular tumor in the depth of the brain. In addition to „conventional MRI“, functional MRI may be performed for localization of functionally important regions of the brain. Co-registration with the actual operation site is accomplished by aid of fiducial markers seen on the preoperative MRI and used for calibration of the robot arm. Following trepanation at the preplanned site, the surgeon implants the US-probe and performs co-registration with the preoperative MRI-modalities and the robot-arm.

The surgical instrument, e.g. an endoscope, may then be introduced to the target area. Small movements of the tip of the instruments are effected either by direct movement of the endoscope or by aid of pedals or of a hand-held guide. Single robotic capabilities such as active constraint to a region of activity and a backtracking tool will be possible. The surgeon perfoms and controls the operation via the intraoperative US-image of his choice (e.g. tomographic slice of the 3D-volume) the preoperative MR-image and its refreshed „intraoperative“ version as well as the endoscopic image. Co-registration between actual US-image and preopeative MRI will thus be performed online; the process of calculation may, however, take several minutes at this stage of technical possibilities. During the operation, further registration may become possible by pointing to predefined landmarks („intracerebral co-registration“).

Results

List of deliverables

List of participants

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