Computer and robotic assisted resection of brain tumours

Six children ages 2 to 10 years harbouring deep brain tumours were operated upon using a computer and robotic assisted system. A radical excision was achieved in all cases with no significant morbidity or any mortality. The system consists of an interactive 3 dimensional (3D) display of computed tomography image contours and digitized cerebral angiograms taken using the BRW stereotactic frame. The surgical retractor is held and manipulated using a PUMA 200 robot. The position and orientation of the surgical retractor is displayed on the 3D display. Preoperative planning and simulation are important features of this system. Movement of the brain following tumour and cerebrospinal fluid removal is substantial so the tumour removal is based on visually defined margins. Enhanced computer graphics and robotic devices are important adjuncts to neurosurgical procedures and will find increasing use in the future.<>