Robot-assisted stereotactic brain biopsy: systematic review and bibliometric analysis

Abstract

IntroductionStereotactic brain biopsy represents one of the earliest applications of surgical robotics. The aim of the present systematic review and bibliometric analysis was to evaluate the literature supporting robot-assisted brain biopsy and the extent to which the scientific community has accepted the technique.MethodsThe Cochrane and PubMed databases were searched over a 30-year period between 1st of January 1988 and 31st of December 2017. Titles and abstracts were screened to identify publications that met the following criteria: (1) featured patients with brain pathology, (2) undergoing stereotactic brain biopsy, (3) reporting robot-assisted surgery, and (4) outcome data were provided. The reference lists of selected studies were also sought, and expert opinion sought to identify further eligible publications. Selected manuscripts were then reviewed, and data extracted on effectiveness and safety. The status of scientific community acceptance was determined using a progressive scholarly acceptance analysis.ResultsAll identified studies were non-randomised, including 1 retrospective cohort study and 14 case series or reports. The diagnostic biopsy rate varied from 75 to 100%, and the average target accuracy varied from 0.9 to 4.5 mm. Use of the robot was aborted in two operations owing to geometric inaccessibility and an error in image registration but no associated adverse events were reported. A compounding progressive scholarly acceptance analysis suggested a trend towards acceptance of the technique by the scientific community.ConclusionsIn conclusion, robot-assisted stereotactic brain biopsy is an increasingly mainstream tool in the neurosurgical armamentarium. Further evaluation should proceed along the IDEAL framework with research databases and comparative trials.

Structural design of a positioning spherical parallel manipulator to be utilized in brain biopsy

“…Using Equation (8), the required position of the platform can be calculated with respect to a given tissue target position as x ¼ x t r j j r t j j ; y ¼ y t r j j r t j j ; z ¼ z t r j j r t j j : (9) In order to manipulate the platform of the system to the desired position (Equation (9)), input values of θ 1 and θ 2 can be calculated from Equation (6).…”

“…The results of their work indicated that the designed system is capable of performing sophisticated operations due to its sufficient dexterity and stability. 9 As it can easily be seen in recent literature, assistive robotics in brain surgery shows promising and safe results. It should be noted that, for positioning, most of the utilized robotic systems still use classical industrial grade serial robot manipulators that are converted for general medical use.…”

“…In their latter work, authors simulated four different types of operations including biopsy in three cadaver heads by utilizing the proposed system. The results of their work indicated that the designed system is capable of performing sophisticated operations due to its sufficient dexterity and stability …”

An Overview of Robotics in Functional Neurosurgery

“…Of various surgical procedures undertaken in neurosurgery, highest benefits of robotic intervention can happen in functional neurosurgery. Though a plethora of robotic surgical programs exist, 8,[11][12][13][14] commercially available robots are few and far between. A relatively large number of stereotactic robotic programs have been documented in the literature.…”

The diagnostic quality of needle brain biopsy specimens obtained with different sampling methods – Experimental study

“…Non-diagnostic samples in brain tumour biopsies are reported in up to 24% of cases and diagnostic errors in 10-30% of cases [2][3][4]9 . Various techniques are employed to improve the diagnostic value of brain biopsy methods [10][11][12][13][14][15][16][17][18] .…”