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Robot prototype operating within a standard head coil in magnetic resonance imaging environment. (Credit: University of Hong Kong)

Researchers have designed the first neurosurgical robotic system capable of performing bilateral stereotactic neurosurgery inside a magnetic resonance imaging (MRI) scanner. The MRI-guided robot facilitates less-invasive stereotactic procedures on the patient under general anesthesia because surgeons can accurately control and evaluate the stereotactic manipulation bilaterally to the left and right brain targets in real time. This innovative technological breakthrough can facilitate the treatment of Parkinson’s disease and other neuropsychiatric disorders.

DBS therapy, like a heart pacemaker, can deliver electrical signals through implanted electrodes to the deep brain targets. It helps to restore normal nerve cell activity. Conventional DBS is performed while the patient is awake under local anesthesia. Surgeons have to rely on verbal or physical interactions with the patients to ensure the electrode placement is going well. This surgery demands accuracy in order to target only the tiny nucleus structures and not damage the surrounding critical tissue. Without the intra-operative updates of a surgical “roadmap,” the brain may shift after the skull is opened, which inevitably lowers the targeting accuracy.

The totally magnetic resonance (MR) compatible tele-operated system is driven by liquid and does not generate any electromagnetic interference or affect imaging quality even during the robot operation. A manipulator is designed to perform dexterous operation towards the left-and-right brain targets, and the area required for an invasive anchorage is very small. The compact robot design can be accommodated inside a standard MRI head coil for imaging and intervention. Advanced 3D tracking markers were also developed, which enable fast localization of robot instruments in MRI in real time.

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