The performance of a Skull Base Drilling Robot is limited in cadaver studies mainly due to registration error in current system. In this project, a C-arm cone-beam CT will be used to provide guidance and “no-fly zones” to the robot that properly accounted for anatomical deformations imparted during the surgery. Hopefully, this integration will reduce registration error and improve the performance of the robot in cadaver studies.
Neurosurgeries such as skull base surgeries are often challenging due to the complex anatomy and the critical nature of adjacent neural and vascular structures. The use of image-guided robots in neurosurgeries can provide precise intra-operative guidance and mechanical assistance. Current skull base robot system developed in Prof. Kazanzides’ lab integrated a Stealthstation navigation system, a NeuroMate robotic arm with a six degree-of-freedom force sensor, and 3D Slicer visualization software to allow the use of the robotic arm in a navigated, cooperatively-controlled fashion by the surgeon. Pre-defined virtual fixture has also been developed to constrain the motion of the robot-held cutting tool within safe zone. The system yielded high accuracy in phantom study–0.6 mm average placement error and 0.6 mm average dimensional error. But in cadaver study some bone outside virtual fixture was cut and the typical overcut was 1–2 mm, with maximum about 3 mm. This keeps the robot from being further tested in real clinical trial.
Considering that intra-operatively updating anatomical deformation and registration may be a possible way to increase cutting accuracy, an advanced intra-operative imaging device–C-arm cone-beam CT will be integrated into the robot system. This prototype CBCT imaging system based on a mobile isocentric C-arm has been developed in Prof. Jeff Siewerdsen’s lab in collaboration with Siemens Healthcare (Siemens SP, Erlangen Germany). It has demonstrated sub-mm 3D spatial resolution and soft tissue visibility which are suitable for neurosurgery navigation. The typical acquisition and reconstruction time are ~60s and ~20s respectively which will not interrupt the surgical workflow.
Our specific aims are:
1. Robot System with CBCT and Navigation System
2. Robot System with CBCT but without Navigation System
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Robotic system
C-Arm Cone Bean CT
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