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  • Machine Vision Assisted Stereotactic Neurosurgery, the Initial Experience of NaoTrac System

    Final Number:

    Shinn-Zong (John) Lin MD PhD; Tsung-Lang Chiu MD; Chieh-Hsiao Chen MD, PhD

    Study Design:
    Clinical Research

    Subject Category:
    Stereotactic and Functional Neurosurgery

    Meeting: Congress of Neurological Surgeons 2019 Annual Meeting

    Introduction: One of the most frequently performed procedures in cranial neurosurgery is stereotactic intervention and robotic technology has been introduced to overcome the limitations of freehand, frameless and frame-based approaches in stereotactic neurosurgery. NaoTrac is the first surgical navigation robot with machine vision specially designed for cranial neurosurgery and it is compact enough to fit in the routine clinical setting. The aim of this study is to demonstrate the feasibility and accuracy of NaoTrac in stereotactic cranial neurosurgery.

    Methods: An approved clinical trial was conducted to assess the feasibility and accuracy of the surgical navigation robot. A total of 10 cases of catheter placement for external ventricular drainage were performed by NaoTrac in this clinical trial. Unlike other navigation systems using IR-reflectors for indirect position calculation, NaoTrac use machine vision to directly calculate and map the location of the target into the system.

    Results: Utilization of NaoTrac was feasible throughout the clinical trial and no severe adverse effects associated with the utilization of the surgical robot were observed. The tip of the catheter had been pleased in the lateral ventricle in one attempt for all cases. The preliminary result shows that the mean error was around 1.6 mm at target points. The mean angular deviation was about 1.7 degree. The mean surgical time was 23 minutes.

    Conclusions: The results from this clinical trial has proven that utilization of NaoTrac in stereotactic cranial neurosurgery is feasible. Utilization of the surgical robot provides high procedural accuracy and reduces surgical time. The compact design of the surgical robot allowed it to be effortlessly integrated into the routine workflow. The registration of lesion locations into the system was easy and fast. Other stereotactic neurosurgical operations such as tumor biopsy, depth electrode placement, deep brain simulation electrode positioning and endoscope will be taken places in the near future.

    Patient Care: By developing innovative navigation and robotic techniques for surgeons to improve accuracy, streamline surgical procedures and reduce learning curve, our research has shown a new way to make stereotactic cranial neurosurgery more precise which can lead to shorter anesthesia time and faster recovery.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Identify the feasibility of this cutting-edge surgical navigation robot, 2) Describe the accuracy of a surgical navigation robot with machine vision.


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