From Rigid to Soft Robotic Approaches for Minimally Invasive Neurosurgery

TL;DR

This paper reviews the development of flexible robotic devices for minimally invasive neurosurgery, highlighting advancements from rigid to bio-inspired soft robots and discussing future safety and evaluation challenges.

Contribution

It provides a comprehensive overview of current flexible robotic technologies in neurosurgery and evaluates their potential for safe, minimally invasive intracranial procedures.

Findings

Rigid continuum robots are most developed

Bio-inspired soft and hybrid robots offer future potential

Safety and evaluation challenges remain significant

Abstract

Robotic assistance has significantly improved the outcomes of open microsurgery and rigid endoscopic surgery, however is yet to make an impact in flexible endoscopic neurosurgery. Some of the most common intracranial procedures for treatment of hydrocephalus and tumors stand to benefit from increased dexterity and reduced invasiveness offered by robotic systems that can navigate in the deep ventricular system of the brain. We review a spectrum of flexible robotic devices, from the traditional highly actuated approach, to more novel and bio-inspired mechanisms for safe navigation. For each technology, we identify the operating principle and are able to evaluate the potential for minimally invasive surgical applications. Overall, rigid-type continuum robots have seen the most development, however, approaches combining rigid and soft robotic principles into innovative devices, are ideally situated to address safety and complexity limitations after future design evolution. We also observe a number of related challenges in the field, from surgeon-robot interfaces to robot evaluation procedures. Fundamentally, the challenges revolve around a guarantee of safety in robotic devices with the prerequisites to assist and improve upon surgical tasks. With innovative designs, materials and evaluation techniques emerging, we see potential impacts in the next 5--10 years.