Robotics for Neuroendovascular Therapy

Abstract

In the field of abdominal and pelvic surgery, endoscopic procedures have increasingly utilized robotic surgery, including the da Vinci system (Intuitive Surgical, Sunnyvale, CA, USA). Unlike robotic surgery in these fields, endovascular treatment involves simple movements such as pushing and pulling or twisting catheters and wires, allowing for the creation of relatively straightforward robotic systems that can replicate these endovascular procedures. Recently, there have been clinical applications of this technology in coronary arteries. However, when applying it to cerebral vessels, which have significant curvature and fragility, it is essential to develop a system that can adequately assess and reflect the physical stress on the vessel wall. Furthermore, remote surgery (telesurgery) performed by specialists is one of the most sought-after applications of robotics, but issues remain due to poor communication environments, leading to delays in operation and control difficulties. Additionally, there are ethical concerns regarding the responsibility for adverse events related to robotic surgery, highlighting the urgent need for the establishment of guidelines.