Robotic Automated Skull-Base Drilling

A systematic review of robotic surgery: From supervised paradigms to fully autonomous robotic approaches

“…Another autonomous drilling prototype developed Dillon et al. (2018) 19 employed similar bone features and CNC‐based algorithm as that of Couldwell et al 18 . The robot had 4 degrees of freedom, and a positioning frame was used to attach the robot base to the patient's skull using cranial plating screws for registration (See Figure 4B).…”

“…The robot had a rigid mechanical structure with 5 degrees of freedom (see Figure 4A) which allowed a wide range of drill angles and positions to be achieved as defined by the surgeon. 17,18 The system was tested on cadaveric samples for the translabyrinthine approach. The system completed the bone removal task in 2 min and 30 s within a 1 mm distance from risk structures.…”

“…19 Compared to Couldwell et al's approach, this system used features of bone density and porosity during planning to optimise the drilling force and revolutions per minute near vital structures. 18,20 The strategy was shown to reduce mean force near vital structures by 63%, thereby reducing the risk of accidental collisions and reducing the rate of thermal energy transferred to the surrounding structures. 20 The performance was evaluated by drilling the temporal bone funnel for vestibular schwannoma resections on five cadaver heads.…”

“…(2018) 19 employed similar bone features and CNC-based algorithm as that of Couldwell et al 18 The robot had 4 degrees of freedom, and a positioning frame was used to attach the robot base to the patient's HAN ET AL.…”

“…In comparison, the same procedure may take 2 h for an expert surgeon to perform. 18 Couldwell et al's system demonstrated a concept that can decrease the wound opening time and thus potentially decrease the chance of infection. 17 Another autonomous drilling prototype developed Dillon et al…”