Advanced Neurosurgical Navigation Using a Robotic Microscope Integrated with an Infrared-Based System

Abstract

Advanced neuronavigational techniques include the use of interactive image guidance during surgical procedures. Imaging data acquisition, software, and a digitizer device are the minimal requirements. We present our experience using a system in which a microscope was coupled to a robotic holder. Limitations encountered were related to the need to maintain the patient's head in a fixed position and to easy loss of registration in deep areas. These limitations were overcome by integrating an infrared system that allowed movement of the patient's head during surgery while tracking the accuracy of intraoperative registration. The optoelectronic integration of these two devices gives a "true" navigational system. The technical details of the system, methodology, and preliminary clinical experience are presented.