Li Jinhua, Ma Lianbo, Ma Zhikang, Sun Xinan, Zhao Jianchang
The Key Laboratory of Mechanism Theory and Equipment Design of Ministry of Education, School of Mechanical Engineering, Tianjin University, Tianjin, 300350, China.
National Engineering Research Center of Neuromodulation, School of Aerospace Engineering, Tsinghua University, Beijing, 100084, China.
J Robot Surg. 2024 Dec 30;19(1):35. doi: 10.1007/s11701-024-02195-z.
Magnetic resonance imaging (MRI) offers high-quality soft tissue imaging without radiation exposure, which allows stereotactic techniques to significantly improve outcomes in cranial surgeries, particularly in deep brain stimulation (DBS) procedures. However, conventional stereotactic neurosurgeries often rely on mechanical stereotactic head frames and preoperative imaging, leading to suboptimal results due to the invisibility and the contact with patient's head, which may cause additional harm. This paper presents a frameless, MRI-guided stereotactic neurosurgical robotic system. The robot features a seven-degree-of-freedom (7-DOF) remote center of motion, with five DOFs for preoperative trajectory alignment to the target lesion and two DOFs for defining the depth and twisting motion of the needle during insertion, thus to minimize tissue damage. The system employs interactive MRI guidance for real-time visualization of the puncture process, showing great potential in reducing surgery time, enhancing targeting accuracy, and improving safety. Experiments were conducted on the proposed system to evaluate signal-to-noise ratio (SNR) and geometric distortion. During the simultaneous operation and imaging, the system demonstrated less than 10.02% SNR attenuation and less than 0.1% geometric distortion, ensuring image usability. The free-space positioning accuracy of the system was evaluated using a laser tracker, revealing a tip position repeatability error within 0.3 ± 0.1 mm.
磁共振成像(MRI)可提供高质量的软组织成像且无辐射暴露,这使得立体定向技术能够显著改善颅脑手术的效果,尤其是在深部脑刺激(DBS)手术中。然而,传统的立体定向神经外科手术通常依赖机械立体定向头架和术前成像,由于不可见性以及与患者头部的接触,导致效果欠佳,这可能会造成额外伤害。本文介绍了一种无框架、MRI引导的立体定向神经外科机器人系统。该机器人具有七自由度(7-DOF)的远程运动中心,其中五个自由度用于术前将轨迹对准目标病变,两个自由度用于在插入针时确定针的深度和扭转运动,从而将组织损伤降至最低。该系统采用交互式MRI引导对穿刺过程进行实时可视化,在减少手术时间、提高靶向准确性和改善安全性方面显示出巨大潜力。对所提出的系统进行了实验,以评估信噪比(SNR)和几何失真。在同步操作和成像过程中,该系统的SNR衰减小于10.02%,几何失真小于0.1%,确保了图像的可用性。使用激光跟踪仪评估了该系统的自由空间定位精度,结果显示尖端位置重复性误差在0.3±0.1毫米以内。