Authors: Nader Pouratian, MD PhD
Chen Wu, MD

Robotic technologies have revolutionized several industries, most notably the manufacturing and automotive industries. Many have argued that robotics (in addition to artificial intelligence) will be the basis of the next industrial revolution. Just like other industries, the practice and science of medicine is continually evolving and stands to benefit from the automation and precision of robotics technologies. When integrated with advanced imaging, surgical robotics has the potential to reduce human- and user-related variability, decrease duration of surgery, increase surgical precision, and potentially improve the safety of surgical procedures.

While robotics has been integrated into other surgical practices such as general, colorectal, urological, and gynecological surgery, neurosurgical robotics is a nascent field. The difference in temporal evolution in large part can be attributed to the unique challenges related to the brain and spine, including smaller access corridors and defining a valuable and practical need for robotics. In our current era of healthcare evolution, defining value is of even greater importance.

Defining the path forward requires a multidisciplinary effort - for neurosurgeons and engineers to understand needs and opportunities to forge the most efficient, productive, and useful path. To address these needs, the CNS Annual Meeting will feature a full day pre-meeting symposium on "Surgical Robotics: Engineering to Bedside." This non-CME symposium on Sunday, October 7, has been developed jointly by key opinion leaders across neurosurgical subspecialties (including spine, cranial, and stereotactic neurosurgery) and Cambridge Consultants, who specialize in disruptive innovations and revolutionizing medical therapies through groundbreaking surgical devices.

The symposium will include five segments, each supplemented by a series of breakout sessions where participants can interact firsthand with the current robotic systems and discuss usage with surgeons who have used the systems in clinical practice. In the first segment, speakers will survey the evolution of surgical tools and surgical robotics, to begin to define the needs and opportunities for neurosurgical robotics that supersede current image-guided surgical technologies. The second session will focus on robotics and spine surgery, including applications in training, challenges unique to spinal robotic surgery, the accuracy and precision of robotic spinal instrumentation, and opportunities to impact the field of spinal neurosurgery. The third session will survey cranial robotic surgery, including applications in deep brain stimulation and epilepsy surgery as well as endoscopic surgery, concluding with an interactive discussion of the added-value of robotics and the future state of robotics in cranial neurosurgery. The fourth session will focus on evaluation and assessment of current technology, including efficiency and accuracy tradeoffs, workflows, and clinical needs and engineering tradeoffs. Finally, the fifth session will evaluate future directions, including potential integration of artificial intelligence for preoperative planning and intraoperative support, next-generation user interfaces, and key emerging technologies for robot-enhanced neurosurgery.

By bringing industry leaders, engineers, key opinion leaders, and users in one forum, this groundbreaking symposium aims not only to review the current state and evidence supporting current neurosurgical robotics but to stimulate discussion and an understanding of key technology features that will enable development and assessment of future robotic systems.

SYMPOSIUM OVERVIEW

Session 1: Background/History of Surgical Robotics

• Image-guided Robotics for Neurosurgery
  Garnette Sutherland
• Minimally Invasive Surgical Robotics: Past and Future
  Amy Kerdok
• Historical Trends in Surgical Tools: From Manual to Robotic
  Panel Discussion

Example of a surgical robotic system incorporating in body articulation; developed by Cambridge Consultants

Session 2: Spine Applications of Robotics

• Applications of Robotics in Spine Surgery and Spine Surgery Training
  Michael Y. Wang
• Robotic Development to Fit the Unique Needs of Spine Surgery
  Nicholas Theodore
• Screw Placement Accuracy Using Robotic Assistance and Intraoperative Fluoroscopy
  Louis Chenin
• Current and Future State of Robotics in Spine Surgery
  Panel Discussion

Session 3: Cranial Neurosurgery Applications of Robotics

• Robotic Applications in Deep Brain Stimulation
  David P. Vansickle
• Robotic Applications in Epilepsy
  Jorge A. Gonzalez-Martinez
• Endoscopy and Robotics
  Sarat P. Chandra
• The Current and Future State of Robotics in Cranial Neurosurgery
  Panel Discussion

Session 4: Evaluation and Assessment of Current Technology

• Efficiency and Accuracy Trade-offs in Current Robotic Systems
  Christopher R. Wagner
• Pre-operative Setup and Intraoperative Workflow Considerations for Current Robotic Systems
  Melanie Turieo
• Clinical Needs and Engineering Trade-offs in Today's Cranial and Spine Robots
  Panel Discussion

Session 5: Future Directions

• Advances in Minimally Invasive Robotics for Neurosurgery
  Robert Webster III
• Artificial Intelligence for Pre-operative Planning Support and Postoperative Analysis
  Joe Corrigan
• Next Generation User Interfaces for Spine Surgery
  Serge Roux
• Key Emerging Technology for Robot Enhanced Neurosurgery
  Panel Discussion

Join us between sessions for hands-on breakout sessions with industry leaders in neurosurgical robotics.