Cutting-edge breakthrough for neurosurgeries

University of Hong Kong researchers have developed a cutting-edge interactive multi-stage robotic positioner designed for MRI-guided stereotactic neurosurgery that is poised to transform the field of neurological interventions.

It is aimed at enabling precise surgical procedures and significantly shorten needle insertion time during operations.

Intraoperative magnetic resonance imaging-guided stereotactic neurosurgery is crucial for treating patients with neurological conditions such as brain tumors and Parkinson's disease, as it can assist with interventions involving cannulas or needles, including brain stimulations, biopsies, drug deliveries, ablations and catheter placements in deep brain regions.

Traditional stereotactic neurosurgery can be prone to errors, as brain deformation during the procedure may occur when relying solely on static preoperative MRI images for guiding cannula or needle insertion.

The positioner addresses this challenge by reducing errors and enhancing the precision of instrument positioning.

"Deep brain stimulation surgeries require precise insertion of long needles deep into the brain," said Kwok Ka-wai, an associate professor with the department of mechanical engineering.

"The surgeon can now insert probes or devices for biopsies, laser ablations, or electrode implantations directly at a time with the use of a robotic positioner, without having to carry out multiple insertions."

To improve precision, the technology also has the potential to significantly reduce surgery time. "With the use of robotic positioners, we expect surgery time can be shortened from six hours to one hour in the near future," said Poon Wai-sang, a clinical professor with the department of surgery.

The positioner, initially created in 2018, is the world's first system capable of performing bilateral stereotactic neurosurgery in an MRI environment. The technology has been refined and validated through cadaveric studies and skull model testing, achieving a precision error of less than three millimeters and demonstrating great potential for clinical integration.

The compact and lightweight design (97 x 81 mm, 203 grams) allows the positioner to fit most standard imaging head coils, featuring custom-made miniature wireless omni-directional tracking markers and a zero-electromagnetic-interference system to facilitate robot registration under real-time MRI.

As Hong Kong prepares to install its first intraoperative MRI system in the second half, with two to three more systems expected in the next five years, this groundbreaking robotic positioner is poised to revolutionize the future of MRI-guided neurosurgery.