Neurosurgical Clinic, Department of Neurosurgery and Neurotechnology, Eberhard Karls University, Tuebingen, Germany.
Department of Neurosurgery and Neurotechnology, Institute for Neuromodulation and Neurotechnology, Eberhard Karls University Tuebingen, Germany.
Int J Med Robot. 2021 Oct;17(5):e2282. doi: 10.1002/rcs.2282. Epub 2021 Jun 1.
Safety, efficacy and efficiency of neurosurgical robots are defined by their design (i.e., framed and non-framed) and procedural workflow (PW) (from image to surgery). The present study describes the quality indicators of three different robots in brain and spine surgery.
This single-centre study enrolled 252 patients over a 10-year period. Safety (complication rate) and efficacy (diagnostic yield, pedicle screw placement) were determined. Predictors of workflow efficiency (e.g., skin-to-skin) were evaluated and compared to conventional techniques (neuronavigation, stereotaxy).
All robots showed excellent reliability (97.5%-100%) with low complication rates (4.5%-5.3%) and high efficacy (94.7%-97.7%). Robotics demonstrated a better time-efficiency than neuronavigation. However, there was no shortening of surgery time compared to conventional stereotaxy. Time-efficiency differed significantly between framed and non-framed workflows.
While all neurosurgical robots were reliable, safe and efficacious, there were significant differences in time-efficiency. PWs should be improved to increase the acceptance of robotics in neurosurgery.
神经外科机器人的安全性、有效性和效率取决于其设计（即有框架和无框架）和程序工作流程（PW）（从图像到手术）。本研究描述了三种不同机器人在脑和脊柱手术中的质量指标。
这项单中心研究在 10 年内招募了 252 名患者。确定了安全性（并发症发生率）和疗效（诊断产量、椎弓根螺钉放置）。评估了工作流程效率（例如，皮肤到皮肤）的预测指标，并与传统技术（神经导航、立体定向）进行了比较。
所有机器人的可靠性均达到 97.5%-100%，并发症发生率低（4.5%-5.3%），疗效高（94.7%-97.7%）。机器人比神经导航具有更好的时间效率。然而，与传统的立体定向相比，手术时间并没有缩短。有框架和无框架工作流程之间的时间效率存在显著差异。
虽然所有神经外科机器人都可靠、安全且有效，但在时间效率方面存在显著差异。应改进 PW，以提高机器人在神经外科中的接受度。
